New technique of direct intra-abdominal pressure measurement

To determine the efficacy of 14-Fr PVC round drain in the direct measurement of intra-abdominal pressure.

Fifty consecutive patients undergoing elective laparoscopic surgery in a tertiary teaching hospital were included in this pilot study. Patients underwent laparoscopic cholecystectomy, appendectomy, splenectomy, colectomy and Nissen fundoplication. After creation of pneumoperitoneum and insertion of the trocars as indicated by the operation, a 14-Fr PVC round drain was inserted into the abdominal cavity via one of the laparoscopic ports. It was then connected under sterile conditions to the invasive blood pressure measurement system. Intra-abdominal pressure was gradually increased. Intra-abdominal pressures as measured through the round PVC drain were compared to those measured by the laparoscopic insufflator at 5, 8, 12 and 24 mmHg.

Two hundred measurements using each of the two methods were performed and correlated. The correlation coefficient was 0.996. No complications were observed with this new technique.

Direct measurement of intra-abdominal pressure using 14-Fr PVC round drain is a newly described technique that is simple, fast and credible. Future investigation will be needed to confirm the reliability of this method during postoperative follow-up of intra-abdominal pressures in selected patients.