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to be comparable to 10 min of inflation and desufflation periods, against laparoscopic IRI. So they suggested
it to be more practical for clinical use . It is important to mention that to date there is no human studies to
[49]
assess the role of described laparoscopic/robotic IPC.

CONCLUSION
The potential positive effects of IPC against IRI have been demonstrated by several studies over the past 2
decades. Despite these encouraging findings, IPC has not been routinely used in clinical settings yet. One
of the major reasons of this situation is the very limited number of larger animal and human studies and
regarding conflicting results. The unknown parts of the exact mechanisms, the lack of standard protocols
for its use such as clamping time, number of clamping cycles for remote IPC, using an early window or a
late window, using local IPC or remote IPC, and the all remaining uncertainty regarding this process might
lead clinicians to be hesitant about its clinical use. In their study in 2000, Yellon and Dana asked the
[50]
question: “The preconditioning phenomenon: a tool for the scientist or a clinical reality?” It is nearly passed
two decades, but the same question hasn’t lost its currency yet. We also agree with them and many others
who made great effort on this topic that more work is needed on IRI, IPC and LPC before its adaptation to
clinical settings to become something more than a tool for the scientist.

DECLARATIONS
Authors’ contributions
Substantial contribution to conception and design, and acquisition of data, and analysis and interpretation
of data: Zor M
Drafting the article and revising it critically for important intellectual content: Kangal KO
Giving the final approval of the version to be submitted and any revised version: Zor M

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Patient consent
Not applicable.

Ethics approval
Not applicable.

Copyright
© The Author(s) 2018.

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