Free intra-abdominal fluid
Conditions
Interventions
Group 1: Sequential Fluid Instillation and FAST Examination (In-vivo)
During elective laparoscopic procedures, defined volumes of 0.9 % saline (250 ml, 500 ml, 1000 ml, 1500 ml) are sequentially insti
Sponsors
Bundeswehrzentralkrankenhaus Koblenz
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Age = 18 years (adult participants) Written informed consent obtained prior to participation Scheduled elective laparoscopic procedure under general anaesthesia Normal intra-abdominal anatomy (no major previous abdominal surgery) Feasibility of standardised FAST examination in the supine position No contraindications to intraperitoneal instillation of 0.9 % NaCl
Exclusion criteria
Exclusion criteria: Anatomical alterations of the abdominal cavity (e.g. splenectomy, extended liver resection, hysterectomy, cystectomy, prostatectomy) Obesity grade II or higher (BMI = 35 kg/m²) Pregnancy Presence of follicular or ovarian cysts Acute intra-abdominal inflammation or infection Contraindications to the use of 0.9 % NaCl Refusal to participate or inability to provide informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sensitivity of the FAST (Focused Assessment with Sonography for Trauma) examination for detecting free intra-abdominal fluid depending on the instilled volume. | — |
Secondary
| Measure | Time frame |
|---|---|
| Specificity of the FAST examination Proportion of correctly negative FAST findings at 0 ml of intraperitoneal fluid (baseline). Time point: Before the first fluid instillation. Comparison of detection rates between anatomical regions Comparison of sensitivity across Morison’s pouch, pouch of Douglas (transverse and longitudinal planes), and splenorenal recess. Statistical analysis: One-way ANOVA. Influence of body mass index (BMI) on detection rate Subgroup analysis according to BMI categories (< 25, 25–29.9, = 30 kg/m²). Outcome measure: Change in sensitivity across BMI groups. Effect of scan orientation (transverse vs. longitudinal) in the pouch of Douglas Comparison of detection rates depending on the chosen scanning plane. Outcome measure: Difference in percentage detection rate. Minimal detectable fluid volume (detection threshold) Determination of the fluid volume (ml) at which = 50% of FAST examinations become positive (threshold analysis). Correlation between detection rate and examiner experience Exploratory analysis by examiner experience (= 5 years vs. less experienced operators, if applicable). Influence of previous abdominal surgery on detection rate Comparison of participants with and without prior abdominal surgery. | — |
Countries
Germany
Contacts
Public ContactSebastian Schaaf
Bundeswehrzentralkrankenhaus Koblenz
Outcome results
None listed