title: Feasibility of the use of novel matrix hemostatic sealant (FloSeal) to achieve hemostasis during laparoscopic excision of endometrioma.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology at Campus Bio Medico, University of Rome, Italy. r.angioli@unicampus.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.forename: Roberto
authors.initials: R
authors.lastname: Montera
authors.forename: Patrizio
authors.initials: P
authors.lastname: Damiani
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.forename: Francesco
authors.initials: F
authors.lastname: Plotti
authors.forename: Marzio Angelo
authors.initials: MA
authors.lastname: Zullo
authors.forename: Irma
authors.initials: I
authors.lastname: Oronzi
authors.forename: Corrado
authors.initials: C
authors.lastname: Terranova
authors.forename: Pierluigi Benedetti
authors.initials: PB
authors.lastname: Panici
mesh_terms: 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
chemical_list: C411004:FloSeal Matrix; D006490:Hemostatics