Venous thromboembolism prophylaxis in laparoscopic surgery

The development and technological progress of videosurgery are increasing the number of patients undergoing laparoscopic procedures. Despite the early postoperative mobilisation and limited perioperative tissue injury related to minimal access surgery, laparoscopic procedures remain still not free from venous thromboembolic events. In cases of long and complex laparoscopic surgery, as well as in patients with the presence of concomitant risk factors, the total risk of VTE seems to be much higher. The negative influence of the pneumoperitoneum and anti-Trendelenburg position on the venous outflow, as well as procedure-related coagulation activation, should always be taken into consideration. Despite the well known and widely implemented VTE prophylaxis regimens in surgical patients, the optimal thromboprophylaxis in patients undergoing laparoscopic surgery remains controversial. In the paper a review of the literature concerning current VTE prophylaxis in laparoscopic surgery is presented. The necessity of risk assessment and prophylaxis individualisation is emphasized. The optimal VTE prophylaxis should be related to both the procedure and patient-related risk of thromboembolic complications.