American Journal of Obstetrics and Gynecology (2004) 191, 352e3

www.elsevier.com/locate/ajog

EDUCATION

Veres needle: In memoriam of the 100th birthdayanniversary of Dr Janos Veres, the inventor

Istvan Szabo, MD,* Adam Laszlo, MD, PhD

Hungarian Society of Gynaecologic Endoscopists, Budapest, Hungary

Received for publication December 24, 2003; revised January 22, 2004; accepted January 22, 2004

The Veres-needle, the instrument for the performanceof pneumoperitoneum before laparoscopy, is known allover the world. The 100th anniversary of the birthday ofJanos Veres, the inventor of the needle, gives a good oc-casion to remember him.

The creation of a pneumoperitoneum is the first nec-essary step to successful laparoscopy and visualizationof the abdominal cavity, and the Veres needle is usedcommonly worldwide as an instrument for the achieve-ment of this procedure. However, even in his nativecountry of Hungary, little is known about Janos Veres,the ingenious inventor of the needle. Because his originalstudies on the needle were published in Hungarian andGerman, there is little accessible English literature avail-able on his contributions.1-3 The 100th anniversary ofhis birthday marks an excellent occasion to rememberhim and to acquaint all laparoscopists and others withhis work.

Janos Veres was born in 1903 in Kismajteny, a smallvillage in Hungary. The son of a local stationmaster forthe Hungarian Railways, he was sent to Debrecen, Hun-gary, for Catholic schooling. He subsequently receivedhis medical education at the University of Debrecen,completing his medical degree in 1927. After his trainingin internal medicine, he became head of the Depart-ments of Pulmonology and Internal Medicine at theKapuvar Hospital in Debrecen.

* Reprint requests: Istvan Szabo, MD, 2nd Department of

Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis

University, H-1083, Ull}ooi ut 78/A, Budapest, Hungary.

0002-9378/$ - see front matter � 2004 Elsevier Inc. All rights reserved.

doi:10.1016/j.ajog.2004.01.030

At the time, tuberculosis was very common in Hun-gary, and one of the accepted treatments for pulmonarytuberculosis often involved the puncture of the pleuralcavity and the creation of an artificial pneumothorax.Such interventions carried considerable risks and com-plications, especially direct injury to the lung. Severaltechniques were used to reduce these risks; however,none of the techniques proved to be reliable. Dr Veresinvented a new instrument: an automatic, spring-loaded,dual needle of 8 to 15 cm length (Figure 1). During theinsertion, the blunt inner core of the needle is pushedback by the resistance of the skin and soft tissue, whichallows the sharp-edged outer sheath to penetrate easily.With the loss of resistance on entry into a hollow space(ie, pleural cavity), the inner blunt part of the needlesprings forward and prevents injury to the internal or-gans (ie, lung). In 1936, afterO900 successful procedureswith this new instrument, now known as the ‘‘Veres nee-dle,’’ he published the results in Hungarian2 and 2 yearslater in German.3 However, it was not until the mid1970s, with the widespread practice of endoscopy, thatthe Veres needle became better appreciated.

During World War II, Dr Veres served in the army.After the war, the new communist leaders dismissedhim from his duties at the Kapuvar Hospital by becauseof his educational background and political beliefs. Twoyears later, after ‘‘rehabilitation,’’ he was allowed to re-turn to his previous position at the hospital. His majorclinical interests were in infectious diseases, and he pub-lished papers on leptospirosis and tularemia. He com-pleted his PhD thesis entitled, Clinical Course andTherapy of Tularemia. In 1955, he moved to Budapest,

Szabo and Laszlo 353

the capital of Hungary, where he worked until his retire-ment in 1973. He died of cardiac failure in 1979 at theage of 76 years. He was acknowledged as a highly edu-cated, intelligent, and empathetic person who was al-ways ready to listen to those around him, whetherthey were patients, friends, or family members.

Figure 2 The Veres-medal, which was established in 1977 bythe Hungarian Society of Gynaecologic Endoscopists.

Figure 1 The original Veres-needle.

The contribution of Dr Janos Veres to endoscopicsurgery is immeasurable and helped usher in the modernera of so-called ‘‘minimally invasive surgery.’’ His inven-tion allowed safe entry through the chest wall to treat orcreate a pneumothorax. Later it was used to create anartificial pneumoperitoneum for various treatments thatincluded, interestingly enough, a treatment of severe hic-cups. Today, because of its ease of use and safety, theVeres needle is widely used for the achievement of lapa-roscopic pneumoperitoneum. Despite several modifica-tions and variations, the original ideas and techniquesof the Veres needle remain the same.

In 1997, the Hungarian Society of Gynecologic Endo-scopists established ‘‘The Veres Medal’’ (Figure 2) incommemoration of his contributions. This prestigiousaward acknowledges the clinical and scientific activitiesof gynecologic endoscopists who have made significantcontributions to the advancement of laparoscopy. Thelist of the medal recipients includes Adolf Galinat, Vic-tor Gomel, Stephan Kaali, Adam Magos, Denis Quer-leu, Jordan Philip, and Thomas Pokoly. Additionally,the Kapuvar Hospital, where Dr. Veres first developedhis needle, honored his work by organizing a scientificmeeting in 1999 and by placing a memorial plaque ona wall of the hospital.

References

1. Sandor J, Ballagi F, Nagy A, Rakoczi I. A needle-puncture that

helped to change the world of surgery: homage to Janos Veres. Surg

Endosc 2000;14:201-2.

2. Veres J. Uj legmellkeszıtes [in Hungarian]. Orv Hetil 1936;80:536-7.

3. Veres J. Neues Instrument zur Ausfuhrung von Brust - oder

Bauchpunctionen und Pneumothoraxbehandlung. Deutsch Med

Wochenschr 1938;64:1480-1.