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The pressure profile test is more sensitive and specific than Palmer's test in predicting correct placement of the Veress needle.

Yoong, W.

The pressure profile test is more sensitive and specific than Palmer's test in predicting correct placement of the Veress needle. - 2010

NMUH Staff Publications 152

<p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;"><strong>OBJECTIVES:</strong> Although the majority of laparoscopic complications result from improper&nbsp;<span class="highlight">Veress</span>&nbsp;<span class="highlight">needle</span>&nbsp;<span class="highlight">placement</span>, the safety tests commonly used to determine&nbsp;<span class="highlight">correct</span>&nbsp;<span class="highlight">placement</span>&nbsp;are not always reliable. A prospective observational study (Canadian Task Force Classification II-2) was set up to determine the reliability of&nbsp;<span class="highlight">Palmer's</span>&nbsp;and&nbsp;<span class="highlight">pressure</span>&nbsp;<span class="highlight">profile</span>&nbsp;tests in&nbsp;<span class="highlight">predicting</span>&nbsp;the<span class="highlight">correct</span>&nbsp;intraperitoneal&nbsp;<span class="highlight">placement</span>&nbsp;of the&nbsp;<span class="highlight">Veress</span>&nbsp;<span class="highlight">needle</span>&nbsp;prior to insufflation.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">STUDY DESIGN:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">One hundred consecutive women undergoing gynaecological laparoscopic surgery between September 2006 and June 2007 were recruited. The operating surgeons conducted&nbsp;<span class="highlight">Palmer's</span>&nbsp;and&nbsp;<span class="highlight">pressure</span>&nbsp;<span class="highlight">profile</span>&nbsp;tests in all 100 cases and recorded the ease with which these tests were performed and whether or not they felt that the&nbsp;<span class="highlight">needle</span>&nbsp;<span class="highlight">placement</span>&nbsp;was&nbsp;<span class="highlight">correct</span>. They were also asked to comment on the saline drop&nbsp;<span class="highlight">test</span>&nbsp;and double click acoustic&nbsp;<span class="highlight">test</span>&nbsp;if appropriate.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">The overall sensitivity of&nbsp;<span class="highlight">Palmer's</span>&nbsp;<span class="highlight">test</span>&nbsp;was 0.92 while its specificity was 0.5. The overall sensitivity and specificity of the&nbsp;<span class="highlight">pressure</span>&nbsp;<span class="highlight">profile</span>&nbsp;<span class="highlight">test</span>&nbsp;were 0.99 and 0.75, respectively, making this a&nbsp;<span class="highlight">more</span>&nbsp;reliable&nbsp;<span class="highlight">test</span>&nbsp;for&nbsp;<span class="highlight">predicting</span>&nbsp;intraperitoneal<span class="highlight">placement</span>&nbsp;of the&nbsp;<span class="highlight">Veress</span>&nbsp;<span class="highlight">needle</span>.</span></p><h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">CONCLUSIONS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 17.999801635742188px;"><span style="font-size: 8pt;">The&nbsp;<span class="highlight">pressure</span>&nbsp;<span class="highlight">profile</span>&nbsp;<span class="highlight">test</span>&nbsp;was a&nbsp;<span class="highlight">more</span>&nbsp;reliable guide to confirming the&nbsp;<span class="highlight">correct</span>&nbsp;<span class="highlight">placement</span>&nbsp;of the&nbsp;<span class="highlight">Veress</span>&nbsp;<span class="highlight">needle</span>as a negative&nbsp;<span class="highlight">test</span>&nbsp;is&nbsp;<span class="highlight">more</span>&nbsp;likely to indicate failure to achieve intraperitoneal&nbsp;<span class="highlight">placement</span>.</span></p>

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