abdominal cavity. The Veress needle safety mechanism con­sists of a blunt-tipped spring-loaded inner stylet, which retracts when it meets resistance, revealing a beveled needle (Fig. 3.9 ). Once the needle is passed through the abdominal wall into the peritoneal cavity, the blunt inner stylet rede­ploys. The Veress needle is most often inserted periumbili­cally or in the patient’s left upper quadrant (i.e., at Palmer’s point). Needle placement can be confi rmed by a variety of means. An aspiration syringe with saline is attached to the end of the Veress needle permitting aspiration and ideally revealing only air. Next the saline within the syringe can be injected through the Veress needle to demonstrate free/unob­structed fl ow through the needle. Finally, the needle is attached to insuffl ation tubing to check the intraperitoneal pressure and pressure during insuffl ation. Normal intra­abdominal pressures tend to be very low (<5 mmHg). High pressures can indicate inappropriate needle position. Because the needle insertion is done blindly, there remains a fi nite chance of injury to adjacent viscera or blood vessels. For this reason, we advocate Veress needle insertion at Palmer’s point (just below the left costal margin) where the tenth rib tents the abdominal wall off of the underlying viscera, and, as such, injury to larger blood vessels (i.e., the inferior vena cava, aorta, and iliac vessels) and intestines can be avoided.