VENOUS STASIS DURING LAPAROSCOPIC CHOLECYSTECTOMY

The objectives of this research were (a) to determine the effect of in sufflation at laparoscopic cholecystectomy to 12 mm Hg on femoral veno us blood flow; and (b) to assess the function of intermittent pneumati c compressors (IPC) and intermittent electric calf stimulators (IECS) in the presence of a pneumoperitoneum. Measures of baseline venous blo od flow velocity, femoral vein diameter, and maximum blood flow veloci ty achieved by IPC or IECS were made in the presence or absence of a p neumoperitoneum of 12 mm Hg. The ICP and IECS were randomly allocated to either leg. All measures were made by an experienced sonologist. In sufflation to 12 mm Hg caused a statistically significant decrease in femoral blood flow velocity and was accompanied by a significant incre ase in femoral vein diameter. The IPC and IECS were able to achieve pu lsatile venous blood flow despite the presence of a pneumoperitoneum, but they had no effect on the depressed baseline blood flow velocity. We concluded that insufflation to 12 mm Hg causes significant venous s tasis in the lower limb and that IPC and IECS cannot completely elimin ate this stasis. Further research needs to be done to clarify the opti mal methods of prophylaxis in view of the implications for deep venous thrombosis.