Feasibility of the Use of Novel Matrix Hemostatic Sealant (FloSeal) to Achieve Hemostasis during Laparoscopic Excision of Endometrioma

Roberto Angioli, Ludovico Muzii, Roberto Montera, Damiani P, P Damiani, Patrizio Damiani, Filippo Bellati, Francesco Plotti, Marzio Angelo Zullo, Oronzi I, Irma Oronzi, Corrado Terranova, Pierluigi Benedetti Panici, Panici PB
Journal of Minimally Invasive Gynecology · 2009 · vol. 16(2) , pp. 153–156 · doi:10.1016/j.jmig.2008.11.007 · PMID:19138574 · W1975137023
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This study investigated the feasibility of using FloSeal, a novel matrix hemostatic sealant, to achieve hemostasis during laparoscopic excision of endometriomas.

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Abstract

Study objectiveTo evaluate the use of FloSeal, a 2-component (collagen granules and thrombin) topical hemostatic agent for the control of minor bleeding of the ovarian wall at the end of the laparoscopic stripping procedure for endometriomas.DesignPilot study.SettingTertiary care university hospital.PatientsTwenty consecutive patients who underwent laparoscopic excision of endometriomas were included in the study.InterventionsEight patients was allocated to FloSeal group, whereas the remaining 12 patients were allocated to the control group.Measurements and main resultsAt the end of the laparoscopic stripping procedure for ovarian cyst (diameter between 3 and 6 cm), the ovarian cortex was carefully everted and thoroughly rinsed to identify the precise localization of bleeding spots. In the FloSeal group the sites of bleeding were covered with FloSeal under direct vision with a laparoscopic applicator. Gentle pressure on the ovary was applied for 5 minutes and subsequently bleeding sites were reexamined. In the control group hemostasis was obtained with conventional methods. Hemostasis was obtained in all cases by 3 minutes from FloSeal application in both study arms. The time of hemostasis was similar in control and FloSeal groups with a median time of 172 and 182 seconds, respectively.ConclusionThis preliminary series suggests that FloSeal may be used instead of bipolar electric coagulation after excision of ovarian endometriomas. Because the latter was identified by some authors as a possible cause of follicular damage, the use of FloSeal for bleeding control should be investigated in patients undergoing laparoscopic stripping of endometriomas.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Gelatin Sponge, Absorbable Hemostasis, Surgical Hemostatics Laparoscopy Ovarian Cysts Adult Endometriosis Female Gelatin Sponge, Absorbable Gynecologic Surgical Procedures Gynecologic Surgical Procedures Hemostasis, Surgical Hemostatics Humans Laparoscopy Middle Aged Ovarian Cysts Pilot Projects Young Adult

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