Veress needle perforation of jejunum.
A 61-year-old man who underwent a laparoscopic fundoplication. He complained of severe abdominal pain after the operation, which got worse over the following 48 hours. He developed localized peritonitis in the left side of the abdomen.
At operation a small perforation was found in a proximal loop of jejunum. The arrow points to the perforation. This was associated with local soiling and peritoneal inflammation. The defect was sutured closed. A Veress needle had been used to induce the pneumoperitoneum.
Comment: Laparoscopic surgery is not without its risks, one being damage to underlying structures at the time of initial instrumentation. For this reason, the Veress needle is used infrequently and many surgeons prefer to use some technique which is less 'blind' in its approach to the abdomen. Despite the adverse publicity attached to the Veress needle, more injuries are associated with trochars than the needle.
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