Comparing Feasibility and Safety in Creation of Pneumoperitoneum by Veress Needle Placed at Supraumbilical, Palmer’s, and Jain’s Point in Laparoscopic Surgeries at a Tertiary Care Center—A Randomized Control Trial

A BSTRACT Background: Laparoscopic surgery has become a cornerstone of modern surgical practice due to its minimally invasive approach, offering quicker recovery, reduced pain, and fewer complications. A critical aspect of these procedures is the safe and efficient creation of pneumoperitoneum, commonly performed using the Veress needle. This study evaluates the feasibility and safety of Veress needle insertion at three anatomical sites: the supraumbilical, Palmer’s, and Jain’s points. Methods: A randomized controlled trial was conducted at a tertiary care center, including 204 patients undergoing laparoscopic surgeries. Participants were randomly assigned into three groups ( n = 68 per group) based on the insertion site of the Veress needle. Parameters, such as time taken for pneumoperitoneum creation, number of attempts, reinsertion rates, intraoperative complications, postoperative pain, infection rates, and hospital stay, were analyzed. Results: Palmer’s point demonstrated the shortest time to pneumoperitoneum creation (84 ± 8 sec), the highest single-attempt success rate (97.1%), and the lowest complication rates. Jain’s point had the highest reinsertion and complication rates, while the supraumbilical site showed moderate results. Postoperative outcomes were best at Palmer’s point, with the least pain scores and shortest hospital stays. Conclusions: In conclusion, Palmer’s point proves to be the safest and most efficient site for Veress needle insertion in laparoscopic surgeries, minimizing both intraoperative and postoperative complications. It is especially favorable in patients with prior abdominal surgeries or high-risk anatomical conditions.