BACKGROUND: Piezoresistive pressure measurement technique (PRM) has previously been applied for direct IAP measurement in a porcine model using two different devices. Aim of this clinical study was to assess both devices regarding complications, reliability and agreement with IVP in patients undergoing elective abdominal surgery. METHODS: A prospective cohort study was performed in 20 patients randomly scheduled to receive PRM either by a Coach-probe or an Accurate(++)-probe (both MIPM, Mammendorf, Germany). Probes were placed on the greater omentum and passed through the abdominal wall paralleling routine drainages. PRM was compared with IVP measurement by t-testing and by calculating mean difference as well as limits of agreement (LA). RESULTS: There were no probe related complications. Due to technical limitations, data could be collected in 3/10 patients with Coach and in 7/10 patients with Accurate++. Analysis was carried out only for Accurate++. Mean values did not differ to mean IVP values. Mean difference to IVP was 0.1 +/- 2.8 mmHg (LA: -5.5 to 5.6 mmHg). CONCLUSION: Direct IAP measurement was clinically uneventful. Although results of Accurate++ were comparable to IVP, the device might be too fragile for IAP measurements in the clinical setting. Local ethical committee trial registration: EK2024.