Schwenk W, Bohm B, Fugener A, Muller JM.
Intermittent pneumatic sequential compression (ISC) of the lower extremities
prevents venous stasis during laparoscopic cholecystectomy. A prospective
randomized study.
Surg Endosc 1998 Jan;12(1):7-11

Department of General Surgery, Charite, Medical Faculty of the Humboldt
University, Berlin, Germany.

BACKGROUND: Fifty patients were included in a prospective randomized trial to
evaluate the efficacy of intermittent sequential compression (ISC) of the lower
extremities in preventing venous stasis during laparoscopic cholecystectomy.
METHODS: We treated 25 patients with (+ISC) and 25 without (-ISC) intermittent
sequential compression. Peak flow velocity (PFV) and cross-sectional area (CSA)
of the right femoral vein were measured by Doppler ultrasound before, during, and
after capnopneumoperitoneum with 14 mm Hg. RESULTS: PFV was 26.4 (8.4) cm/s and
CSA was 1.03 (0.23) cm2 before pneumoperitoneum was induced. During abdominal
insufflation, PFV decreased to 61% of the baseline value in the (-ISC) group but
remained unchanged in the (+ISC) group (t = 5.17, df = 42.8, p < 0.01). CSA was
1.06 (0.22) cm2 before insufflation. It increased to 118% of the baseline in the
(-ISC) group and to 108% in the (+ISC) group (t = -1.55, df = 47.1, p = 0.13).
PFV and CSA returned to baseline values within 5 min after abdominal
desufflation. CONCLUSIONS: ISC effectively neutralizes venous stasis during
laparoscopic surgery and may decrease the risk of post-operative thromboembolic
complication. Therefore, it is recommended for all prolonged laparoscopic
procedures.