Intraperitoneal Drain (IP Drain)

What is ascites?

The peritoneum is thin tissue (membrane) that lines the inside of your abdominal (belly) cavity. Some of your abdominal organs are found inside this membrane, such as your stomach, intestines, appendix, liver, and spleen. The space inside this membrane is called “intraperitoneal.” Ascites is the buildup of extra fluid in this space.

Ascites can cause:

• Discomfort.
• Weight gain.
• Feeling full or not hungry.
• Nausea.
• Infection.
• Trouble breathing.

Ascites is often caused by cirrhosis (scarring) of the liver. It can also be caused by cancer, often in late-stage or recurrent (keeps coming back) cancers. Paracentesis is a procedure that uses a needle to drain this fluid. In many cases, the fluid comes back quickly after it is drained. When the fluid needs to be drained often, a drain may be placed.

What is an intraperitoneal (IP) drain?

An intraperitoneal drain (IP drain) is a thin tube placed into the abdomen (belly). It is used to remove fluid from the intraperitoneal space. There are two kinds of IP drains:

• A tube comes out of the skin and can be attached to a drainage container when needed. These tubes have a clamp or other device to prevent leaking when the container is not attached.
• Some drains do not have a tube, but instead a small port that sits under the skin that can be punctured (poked) with a needle that is attached to a drainage container.

In both kinds of IP drains, the fluid is drained into a container by either you, a caregiver, or a nurse. This can be done at home and there is no need to go to your provider’s office.

You and your caretaker will be given instructions about how to take care of your drain and how often to drain the fluid. IP drains are used to help with the symptoms of ascites and to help you be more comfortable. It does not treat the cause of the ascites.

How do I prepare for the procedure?

Your provider will go over how to prepare for a drain placement, including which medications to stop taking and when.

How is the IP drain placed?

IP drains are often placed in the Interventional Radiology (IR) department by a doctor called an Interventional Radiologist. They may also be placed in the operating room (OR). Most times this is done as an outpatient procedure and you can go home after. Your provider will go over your procedure and what will happen, but in general:

• You will lie on your back.
• An IV will be placed in your hand or arm. You will receive medication to keep you calm or to help you sleep. Medications may also be used to numb the incision area.
• You will be hooked up to monitors to track your heart rate and blood pressure.
• Incision(s) will be made in your belly to tunnel the catheter to the intraperitoneal space.
• If you have a tube system, the tube will be stitched to your skin and the area will be covered with a bandage. If you have a port system, the incisions will be closed after stitching or gluing the port in place.
• An x-ray or other imaging test may be done to make sure the drain is in the right place.

When should I call my healthcare provider?

After you have had your drain placed and are cleared to go home, your care team will go over any changes you'll need to make in your activity level. They will also talk to you about how to care for your drain, supplies needed to drain your ascites, and how often/how much you should drain.

• Ask your provider when you can go back to your normal day-to-day activity.
• Call your provider if you have:
  • Bleeding, drainage, redness, or pain at any of the incisional areas.
  • Fever. Your care team will tell you at what temperature you should call.
  • The tube or port does not drain fluid when accessed/opened.

An intraperitoneal drain can be very helpful if you have ascites that keeps building up. Call your provider with any questions or concerns you may have about this procedure.