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Correspondence |
Calgary, Alberta
To the Editor:
Ganapathy stated in his editorial1 that Bier introduced spinal anesthesia in 1899.1 Bier published six cases in 1899, but he administered the first spinal the year before: "On August 16, 1898, at 8:35 a.m., I injected 3 cc of 0.5% solution of cocaine (0.015 g) in the manner I have described [lateral position, Quincke's technique, and fine hollow needle] and waited 20 min. Sensation was lost in the lower half of the body."2,3 The patient was a 34-yr-old man with disseminated tuberculosis and an inflamed tuberculous ankle joint.
In the same issue of the Journal, Ishiyama et al. wrote that, "A Verres [sic] needle was inserted in the right subcostal area."4 Janos Veress (not Verres or Verré) was a Hungarian physician who described his needle in 1938.5,6 He designed it to prevent damage to lungs or abdominal organs, either during removal of fluid from the thoracic or peritoneal cavities, or during treatment of pneumothorax. The blunt tipped cannula was connected to a spring, and was slightly longer than the sharply-pointed external needle. The cannula was held back by the skin and other solid tissue during insertion until the tip of the needle penetrated the pleura or peritoneum. The blunt end of the spring-loaded cannula then advanced automatically with, supposedly, no danger to internal organs. Ishiyama et al.'s report, and those of gynecologists and surgeons,7,8 remind us that this may not be true when the Veress needle is used for insufflation, rather than drainage, of the peritoneal cavity.
References
1
Ganapathy S. Walking spinals: a myth or reality? Can J Anesth 2001: 48; 222–4.
2 Bier A. Versuche über Cocainisirung des Rückenmarkes (German). Deutsche Zeitschrift für Chirurgie 1899; 51: 361–9.
3 Bier AKG. Experiments in cocainization of the spinal cord. In: Faulconer A, Keys TE (Eds.). Foundations of Anesthesiology Vol. 2. Springfield: Charles C. Thomas, 1965: 850–7 (Reprinted 1993 by the Wood Library-Museum of Anaesthesiology 520 N Northwest Highway, Park Ridge, IL 60068-2573, USA.
4
Ishayama T, Kazuyuki H, Kashimoto S, Kumazawa T. Pulmonary carbon dioxide embolism during laparoscopic cholecystectomy. Can J Anesth 2001; 48: 319–20.
5 Veress J. Neues Instument zur Ausfuhrung von Brust-oder Bauch-punktionen und Pneumothoraxbehandlung (German). Disch Med Wochenshr 1938; 41: 1480–1.
6 Bridgewater FHG, Mouton WG. Rationale and intended use for the Veress needle: a translation of the original descriptive article. Surg Laparosc Endosc 1999; 9: 241–3.
7 Endler GC, Moghissi KS. Gastric perforation during pelvic laparoscopy. Obstet Gynecol 1976; 47(Suppl.): 40s–2.[Medline]
8 Yerdel MA, Karayalcin K, Koyuncu A, et al. Direct trocar insertion versus Veress needle insertion in laparoscopic cholecystectomy. Am J Surg 1999; 177: 247–9.[Medline]
London, Ontario
To the Editor:
Introduction of a technique, in my opinion, occurs when the technique is published in a journal of communication. If I were to incorporate the details on spinal anesthesia, the sentence should read: "Dr. Bier administered the first spinal anesthetic in 1898".
While I accept the change in detail, I decline the "gender change" implied in Dr. Maltby's letter. Thus it should read: "Ganapathy stated in her/his editorial...".
Yamanashi, Japan.
We thank Dr. Maltby for his comments concerning our report "Pulmonary carbon dioxide embolism during laparoscopic cholecystectomy".1 In many reports, the needle that established pneumoperitoneum for laparoscopic procedure was described as "Verres" needle.2,3 We checked on Medline and found that 37 papers are used the word "Verres" in their titles or abstracts. On the other hand, plenty of other papers mentioned the needle as "Veress".4,5 Both descriptions may be accepted.
Verres or Veress needle is widely used for insufflation of carbon dioxide to establish a pneumoperitoneum. However, Verres or Veress needle-related several accidents such as bile duct, hepatic, vascular, and gastrointestinal injuries have been reported.1,4 Therefore, new trocars have been developed to overcome the disadvantages of the Verres or Veress needle.5
References
1 Ishiyama T, Hanagata K, Kashimoto S, Kumazawa T. Pulmonary carbon dioxide embolism during laparoscopic cholecystectomy. Can J Anesth 2001; 48: 319–20.
2 Borgatta L, Gruss L, Barad D, Kaali SG. Direct trocar insertion vs. Verres needle use for laparoscopic sterilization. J Reprod Med 1990; 35: 891–4.[Medline]
3 Derouin M, Couture P, Boudreault D, Girard D, Gravel D. Detection of gas embolism by transesophageal echocardiography during laparoscopic cholecystectomy. Anesth Analg 1996; 82: 119–24.[Abstract]
4 Lantz PE, Smith JD. Fatal carbon dioxide embolism complicating attempted laparoscopic cholecystectomy- -case report and literature review. J Forensic Sci 1994; 39: 1468–80.[Medline]
5 Bemelman WA, Dunker MS, Busch OR, Den Boer KT, de Wit LT, Gouma DJ. Efficacy of establishment of pneumoperitoneum with the Veress needle, Hasson trocar, and modified blunt trocar (TrocDoc): a randomized study. J Laparoendosc Adv Surg Tech A 2000; 10: 325–30.[Medline]
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