Usefulness of hemostatic sealants for minimizing ovarian damage during laparoscopic cystectomy for endometriosis

Chahien Choi, Woo Young Kim, Dong Hee Lee, San Hui Lee
Journal of Obstetrics and Gynaecology Research · 2017 · vol. 44(3) , pp. 532–539 · doi:10.1111/jog.13542 · PMID:29271052 · W2777621177
article OA: closed CC0 ⤵ 25 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This study found that hemostatic sealants preserved ovarian reserve better than bipolar coagulation, as shown by a smaller decrease in anti-Müllerian hormone levels three months after laparoscopic endometriotic cystectomy.

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Abstract

AIM: We aimed to evaluate the impact of topical hemostatic sealants and bipolar coagulation during laparoscopic ovarian endometriotic cyst resection on ovarian reserve by comparing the rates of decrease in anti-Müllerian hormone (AMH). METHODS: A randomized prospective data collection was made on women aged 19-45 years who planned to have laparoscopic ovarian cystectomy at one of two institutions (n = 80), Kangbuk Samsung Hospital, Seoul, Korea or National Health Insurance Service Ilsan Hospital, Goyang, Korea, from January 2014 to April 2016. Patients were randomly divided into two groups treated with either a topical hemostatic sealant or bipolar coagulation for hemostasis. The hemostatic group was randomized to the FloSeal or TachoSil subgroups. Preoperative and 3-month postoperative AMH levels were checked and the rates of decrease of AMH were compared. All patients enrolled were treated with dienogest (Visanne) for 6-12 months. None were lost to follow-up at postoperative 3 months, but about one-third of the patients had been lost to follow-up by 6-12 months. RESULTS: AMH was significantly decreased in both groups 3 months postoperatively; however, the rate of decrease in the bipolar coagulation group was greater than that in the hemostatic sealant group, 41.9% (interquartile range [IQR], 22.29-65.24) versus 18.1% (IQR, 10.94-29.90), P = 0.007. Between the two hemostatic subgroups, there was no significant difference in AMH decrease rate, 14.95% (IQR, 11.34-21.21) versus 18.1% (IQR 9.76-40.70), P = 0.204. CONCLUSION: Hemostatic sealants may be an alternative to bipolar coagulation for preservation of ovarian reserve after laparoscopic ovarian cystectomy for endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Anti-Mullerian Hormone Endometriosis Gynecologic Surgical Procedures Hemostasis, Surgical Hemostatics Hemostatic Techniques Laparoscopy Outcome Assessment, Health Care Ovarian Cysts Ovarian Reserve Adult Anti-Mullerian Hormone Endometriosis Female Gynecologic Surgical Procedures Hemostasis, Surgical Hemostatics Humans Laparoscopy Middle Aged

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References (30)

Cited by (25)

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