Visually assisted entry of a Veress needle with a tapered videoscope for microlaparoscopy

In combination, a Veress needle for facilitating pneumolaparoscopic surgery and a visualization stylet, comprising:

• the Veress needle having a sharp puncturing tip at a distal end of a hollow needle within which a spring-loaded insufflation tube is positioned, the hollow needle being configured for insertion into a patient to form a cavity for the pneumolaparoscopic surgery,
• the insufflation tube having an essentially flat distal end through which gas can be delivered by the Veress needle and being retractable against spring pressure into a lumen of the hollow needle when the Veress needle is pushed against a surface,
• the visualization stylet having a distal stylet end and having a proximal handle,
• the stylet having an elongated stylet shaft extending from the handle and sized to be inserted through a proximal end of the Veress needle and into the insufflation tube and out through the distal end of the Veress needle and the insufflation tube by positioning the visualization stylet using the handle, the elongated stylet shaft having a significantly smaller outside diameter than an inside diameter of the insufflation tube throughout the length of the stylet shaft except at said distal stylet end wherein the stylet shaft is of a larger diameter substantially filling the insufflation tube within the Veress needle,
• the visualization stylet being a miniature videoscope, with a digital video camera and lens system positioned centrally at a blunt distal tip and a connecting cable extending from the camera proximally through the elongated stylet shaft for connection to image processing and display equipment,
• illumination means at said blunt distal tip of the stylet shaft positioned adjacent to and alongside the camera and lens system, and
• said smaller outside diameter of the stylet shaft being sufficiently small in diameter as to leave a clearance between the stylet shaft and the insufflation tube, the clearance having an area sufficient to provide a fluid flow path,
• whereby the Veress needle can be inserted through tissue of a patient with the distal stylet end of the visualization stylet just inside the distal end of the Veress needle and inside the insufflation tube to provide video images as the Veress needle is advanced through tissue layers, and whereby, once a desired position for insufflation has been reached with the Veress needle, the distal stylet end can be pushed distally to extend the distal stylet end out from the distal end of the Veress needle, so that the larger-diameter end portion distal stylet end of the stylet shaft is removed from the insufflation tube and insufflation gas can be delivered through the insufflation tube of the Veress needle to open a cavity for pneumolaparoscopic surgery on the patient.