Background : The influence of adhesive skin drapes on abdominal wall compliance during laparoscopy has not previously been studied. Methods : The effect of removing an adhesive abdominal drape on intraperitoneal volume and pressure was studied in 15 patients undergoing a variety of laparoscopic procedures. The internal consistency of this data was evaluated by comparing the observed response to that which was predicted from analysis based on the theory of elasticity. Results : Removal of an adhesive skin drape after induction of a 15-mmHg pneumoperitoneum was associated with changes in intraperitoneal pressure and volume. These changes were statistically significant, highly predictable and clinically relevant. Conclusions : On the basis of the present observations, we recommend that extensive coverage by adhesive drapes should be avoided for those patients or procedures in which elevated intraperitoneal pressure may be particularly deleterious. ; Mark Siddins, John Boland, Marcus Riederer, Burapa Kanchanabat, M. Mohan Rao, Peter Hewett