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Background <p>The Veress Needle (VN) is commonly used in establishing pneumoperitoneum in laparoscopic surgery. However, severe vascular and/or visceral complications can occur due to overshoot at the insertion of the VN in the abdominal cavity. In order to investigate whether the new VeressPLUS needle (VN+) could improve safety, the learning curve of this needle was compared to that of a conventional VN, under standardized conditions.</p> Methods <p>In total, 26 residents and med students, without prior Veress needle experience, were recruited and randomly assigned to VN or the VN+ group. A learning curve plateau phase recognition model was developed and used to determine the learning curve of the participants who used either the VN or the VN+ needle on two Thiel-embalmed human cadavers. Insertion of the needles was done in a systematic way in the upper abdomen and insertion depth was measured under direct laparoscopic vision. At the end of the learning curve, the number of participants that reached a safe insertion depth between 5 and 15&#xa0;mm was compared.</p> Results <p>On average, it took the VN group 8 trials to reach and establish the plateau phase of the learning curve. The VN+ group showed no learning curve at all. At the 8th trial, a significant difference (<i>p</i> &lt; 0.002) in average insertion depth was found in favor of the VN+ (mean: 5.4&#xa0;mm SD 1.4) compared to the VN (mean: 12.7&#xa0;mm SD 6). In the VN group and VN+ group, 46% versus 8% exceeded the safe insertion depth of 10&#xa0;mm at the end of the learning curve.</p> Conclusion <p>This study indicates that for novices, there is no learning curve for the VN+, when compared to VN. Moreover, in all cases, the insertion depths were significantly reduced (with more than 50%) while using the VN+ when compared to the VN.</p>

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Learning curve estimation and insertion depth in Veress needle insertion using a conventional Veress needle and the VeressPlus™ needle

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月9日

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  • Tim Horeman-Franse,
  • Roelf Postema,
  • David Cefai,
  • Sem Frederik Hardon,
  • Predrag Andrejevic,
  • Jenny Dankelman,
  • Jean Calleja-Agius,
  • Christian Camenzuli

摘要

Background

The Veress Needle (VN) is commonly used in establishing pneumoperitoneum in laparoscopic surgery. However, severe vascular and/or visceral complications can occur due to overshoot at the insertion of the VN in the abdominal cavity. In order to investigate whether the new VeressPLUS needle (VN+) could improve safety, the learning curve of this needle was compared to that of a conventional VN, under standardized conditions.

Methods

In total, 26 residents and med students, without prior Veress needle experience, were recruited and randomly assigned to VN or the VN+ group. A learning curve plateau phase recognition model was developed and used to determine the learning curve of the participants who used either the VN or the VN+ needle on two Thiel-embalmed human cadavers. Insertion of the needles was done in a systematic way in the upper abdomen and insertion depth was measured under direct laparoscopic vision. At the end of the learning curve, the number of participants that reached a safe insertion depth between 5 and 15 mm was compared.

Results

On average, it took the VN group 8 trials to reach and establish the plateau phase of the learning curve. The VN+ group showed no learning curve at all. At the 8th trial, a significant difference (p < 0.002) in average insertion depth was found in favor of the VN+ (mean: 5.4 mm SD 1.4) compared to the VN (mean: 12.7 mm SD 6). In the VN group and VN+ group, 46% versus 8% exceeded the safe insertion depth of 10 mm at the end of the learning curve.

Conclusion

This study indicates that for novices, there is no learning curve for the VN+, when compared to VN. Moreover, in all cases, the insertion depths were significantly reduced (with more than 50%) while using the VN+ when compared to the VN.