Direct trocar versus veress needle for creation of pneumoperitoneum during diagnostic laparoscopy in patients with infertility

Objective: To compare direct trocar and veress needle technique for creation of pneumoperitoneum during diagnostic laparoscopy in infertile patients with regard to safety and duration of procedure.
Methods: Retrospective study was conducted from march 2013 to April 2018 and two hundred diagnostic laparoscopies done by single surgeon for infertility evaluation including 100 cases done between march 2013 to janurary 2016 by veress needle and 100 cases done between feburary 2016 to april 2018 by direct trocar for creation of pneumoperitoneum in five private hospitals of Kashmir valley. Results: Procedure was quick with direct trocar (3.8±0.5 min.) compared to veress needle technique (6.2± 1.0 min.). The complications like conversion to open surgery, port site bleeding, preperitoneal emphysema, omental bleeding and port site endometriosis were more common with veress needle as compared to direct trocar technique.
Conclusion: Direct trocar insertion is rapid and safe as compared to veress needle for creation of pneumoperitoneum.