RESEARCH ARTICLE
Unusually High Intra-abdominal Opening Pressure Confirmed by Simultaneous Gastric Pressure Measurement during Laparoscopy
Richard Matulewicza, *, Antonio R. Gargiulob, Stephen H. Loringc, Massimo Ferrignoa
Article Information
Identifiers and Pagination:
Year: 2012Volume: 6
First Page: 12
Last Page: 15
Publisher ID: TOATJ-6-12
DOI: 10.2174/1874321801206010012
Article History:
Received Date: 25/10/2011Revision Received Date: 26/01/2012
Acceptance Date: 27/01/2012
Electronic publication date: 7/3/2012
Collection year: 2012
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
A 28 year-old obese woman was scheduled for robot-assisted bilateral tubal re-anastomosis under general anesthesia and neuromuscular blockade. As part of a respiratory mechanics study, gastric pressure (Pga) was measured. At the beginning of the operation, the surgeon repeatedly inserted a Veress needle consistently measuring an unusually high opening pressure of 15 mmHg, at a time when Pga was 12.5 mmHg. Based on the elevated Pga values, we inferred that the high opening pressure was a valid intra-peritoneal pressure, rather than a sign of incorrect needle placement; therefore, the surgeon proceeded with uneventful insufflation of the peritoneal cavity. This patient exhibited an unusually high opening intra-abdominal pressure that likely reflected her high degree of central obesity. Simultaneous Pga determination proved valuable in confirming intra-peritoneal location of the tip of Veress needle and may be a viable method of corroborating high opening pressures despite safe needle positions in laparoscopic cases.
