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Study of venous blood flow changes during laparoscopic surgery using a thermodilution technique
N J Marshall1, J R Bessell, G J Maddern
1Department of Surgery, University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia, Australia.
The Australian and New Zealand Journal of Surgery
|September 8, 2000
Summary
Intraoperative femoral venous blood flow was measured during laparoscopic surgery. Sequential compression devices did not predictably increase blood flow, suggesting they may not fully prevent deep venous thrombosis (DVT).
Area of Science:
- Vascular Surgery
- Minimally Invasive Surgery
- Thrombosis Research
Background:
- Deep venous thrombosis (DVT) is a risk during laparoscopic surgery.
- Existing methods for analyzing DVT risk factors are numerous.
- Intraoperative femoral venous blood flow has not been directly measured in this context.
Purpose of the Study:
- To measure intraoperative femoral venous blood flow during laparoscopic surgery.
- To assess the influence of sequential compression devices (SCDs) on femoral venous blood flow.
- To evaluate the effectiveness of SCDs in preventing DVT.
Main Methods:
- Thermodilution technique used for cardiac output measurement adapted for femoral vein blood flow.
- Measurements taken during laparoscopic cholecystectomy.
- DVT prophylaxis included SCDs and subcutaneous heparin.
Main Results:
- Pneumoperitoneum and Trendelenburg position decreased femoral venous return in most patients.
- SCDs did not predictably restore blood flow to baseline levels.
- Femoral blood flow was not consistently enhanced by SCDs.
Conclusions:
- Thermodilution is a reliable technique for blood flow measurement.
- Anesthetic agents and laparoscopic procedures can affect hemodynamic variations.
- SCDs alone may be insufficient for adequate DVT prophylaxis due to unpredictable effects on femoral blood flow.