Feasibility of the use of novel matrix hemostatic sealant (FloSeal) to achieve hemostasis during laparoscopic excision of endometrioma.
OBJECTIVE
To 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.


METHODS
Pilot study.


METHODS
Tertiary care university hospital.


METHODS
Twenty consecutive patients who underwent laparoscopic excision of endometriomas were included in the study.


METHODS
Eight patients was allocated to FloSeal group, whereas the remaining 12 patients were allocated to the control group.


RESULTS
At 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.


CONCLUSIONS
This 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.
Angioli
Roberto
R
Department of Obstetrics and Gynecology at Campus Bio Medico, University of Rome, Italy. r.angioli@unicampus.it
Muzii
Ludovico
L
Montera
Roberto
R
Damiani
Patrizio
P
Bellati
Filippo
F
Plotti
Francesco
F
Zullo
Marzio Angelo
MA
Oronzi
Irma
I
Terranova
Corrado
C
Panici
Pierluigi Benedetti
PB
D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000601:surgery*; D010865:Pilot Projects; D055815:Young Adult
C411004:FloSeal Matrix; D006490:Hemostatics