Muhammad Nadeem, MD1, Steven Schwaitzberg, MD1, John Butsch, MD2. 1University at Buffalo, 2Buffalo General Medical Center
Introduction: Obese patients suffer from multiple organ comorbidities which contribute to a shortened lifespan . One of the effects of obesity is thought to be pseudotumor cerebri, which is secondary to increase in intracranial pressure (ICP) in the absence of an obstruction. Over the past two years, we have measured ICP after insufflating with a laparoscopy device. We found that ICP increases dramatically and it correlates with the amount of insufflation in the abdomen. Over the years, there have been studies in obese patients and intra-abdominal pressure. These studies have shown that some obese patients have an intra-abdominal pressure of 15 to 18 mm Hg. Increasing intraabdominal pressure is thought to escalate intracranial pressure (ICP). The objective of this pilot study was to observed change in ICP after the raising intra-abdominal pressure.
Method: In this retrospective chart review preliminary study, pressure in each of the patients either normal pressure hydrocephalous or high pressure hydrocephalous receiving a ventricle shunt were measured by manometer. Once the shunt was placed into the ventricle, we attached a manometer to measure the opening pressure. After we accessed the abdominal cavity using the standardoptiview technique, we created a pneumoperitoneum. after achieving an intraabominal pressure of 15mmhg, were measured the ICP using the manometer.
SPSS software version 24 was used for data analysis. Paired t-test was applied on ICP before and after the procedure.
Results: We had included 10 patients (80% female, 20% male) mean body mass index (BMI) 28.433. Their ICP were raised statistical significantly (p-value<.001, 95%CI -9.348 – -4.51, r: 0.822) from mean 16.7 mm of Hg to mean 23.63 mm of Hg with each 4.67 mm of Hg standard deviation (SD).
Conclusion: The Laparoscopic abdominal procedure raises the ICP. Therefore, we can surmise of increasing intra-abdominal pressure directly increase the ICP. Therefore obese patients who have inherently a high intraabdominal pressure will have higher ICP and This can contribute to pseudotumor cerebri . We are also using this model to study other effects of intrabdominal pressure on other comorbidities
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88499
Program Number: P658
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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