Hemodynamic effects of intermittent pneumatic compression of the lower limbs during laparoscopic cholecystectomy.

BACKGROUND The effects of surgical pneumoperitoneum on lower-limb venous hemodynamics have already been studied; however, the effects of intermittent compression boots are not known in such venous-stasis conditions. METHODS In 12 volunteers and 12 patients, the venous hemodynamic effects of intermittent leg compression were studied under external abdominal pressure or during laparoscopic cholecystectomy, respectively. Femoral venous diameter and velocity were measured. Venous pressure was monitored during the surgical procedures. RESULTS External abdominal pressure of 50 mm Hg and pneumoperitoneum were found to increase the diameter (17% in the volunteers and 14% in the patients) and decrease peak velocity (49% and 32%, respectively) in the femoral vein. Femoral pressure was increased (106%) during pneumoperitoneum. In both venous-stasis circumstances, intermittent compression of the legs restored venous flow velocity, but had no effect on vessel diameter and pressure. CONCLUSIONS The lower-limb venous hemodynamic changes were similar during external abdominal pressure or pneumoperitoneum, and the flow velocity decrease was intermittently reversed by pneumatic compression boots.