Microcirculation in lower limbs during laparoscopic cholecystectomy

To study the influence of venous hypertension, which develops in lower limbs under pneumoperitoneal pressure, on microcirculation, plethysmographic measurements were performed in patients before and during laparoscopic and traditional (open) cholecystectomy. During laparoscopy, isovolumetric venous pressure (estimate of capillary pressure), and filtration coefficient (estimate of patent capillary surface) decreased, which was not the case during open surgery. These results indicates that venous hypertension during laparoscopic surgery does not extend to the microcirculation; vasoconstriction is a result of protective mechanisms, which disable excessive fluid filtration in microcirculation. Parameters of macrocirculation (ambient venous pressure, compliance of calf tissue) changed intraoperatively in both groups similarly, irrespectively of the surgical technique.