Laparoscopic management of abdominal ectopic pregnancy using FLOSEAL Hemostatic Matrix

Gorry, Anwen; Morelli, Marie-Laure; Olowu, O.; Shahid, Anupama; Odejinmi, Funlayo

doi:10.1016/j.ijgo.2011.11.003

Cited by 17 publications

(8 citation statements)

References 2 publications

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“…Later Abossolo and colleagues described a case where operative laparoscopy was used in the presence of significant intra‐abdominal haemorrhage. Since then, various methods to control haemorrhage laparoscopically have been described, with the most common being bipolar electrocautery, using an ultrasonic surgical cutting and coagulation device (Harmonic ACE ® [Ethicon Inc., Johnson & Johnson, Somerville, NJ, USA]), using a haemostatic matrix sealant agent (Floseal ™ [Baxter International Inc., Deerfield, IL, USA]), vasopressin and oxidised cellulose (Surgicel ® Fibrillar ™ [Ethicon Inc., Johnson & Johnson, Somerville, NJ, USA]) . Vasopressin analogues used for haemorrhage control carry the risk of injection into vascular areas which can cause cardiac complications, thus should not be used without discussion with the anaesthetist.…”

Section: Treatmentmentioning

confidence: 99%

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Early abdominal ectopic pregnancy: challenges, update and review of current management

Agarwal

Odejinmi

2014

The Obstetric & Gynaecologis

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Key content Early abdominal ectopic pregnancy (EAP), though rare, has a high mortality rate. There are no pathognomic symptoms of abdominal pregnancy. Symptoms are akin as for other types of ectopic pregnancy, thus a high index of suspicion is necessary for diagnosis. The tool of choice for diagnosis is ultrasound but it only gives 50% accuracy when used along with clinical evaluation. On occasion, magnetic resonance imaging may help to diagnose EAP. Medical management is commonly used where potential life‐threatening bleeding is anticipated. A number of women who are treated medically may need subsequent treatment with multiple therapies. Surgical management requires a great deal of surgical expertise and in most cases a multidisciplinary approach in anticipation of possible life‐threatening bleeding during the operation. Learning objectives To outline the classification of EAP. To understand the common risk factors associated with EAP. To understand how to diagnose EAP. To be aware of the different medical and surgical management of EAP and the ethical issues associated with diagnosis and treatment. Ethical issues Distinguishing an abdominal pregnancy from the more common variants of ectopic pregnancy remains difficult and a definitive diagnosis is usually made at surgery. There is no established guidance available for the diagnosis and management of EAP. Many EAP are never diagnosed because of a successful response to medical management for a pregnancy of unknown location. As it is not uncommon to diagnose EAP for the first time during surgery, the difficulties in diagnosis prior to surgery means that patients require life‐saving surgery beyond the scope of the preoperative signed consent form.

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Section: Treatmentmentioning

confidence: 99%

“…The authors reported significant benefits in terms of reduced blood loss and reduced hospital stay in the laparoscopic group compared with the laparotomy group, in keeping with other forms of ectopic pregnancy. There are also case reports where even with haemoperitoneum, EAP was managed surgically by operative laparoscopy …”

Section: Treatmentmentioning

confidence: 99%

Early abdominal ectopic pregnancy: challenges, update and review of current management

Agarwal

Odejinmi

2014

The Obstetric & Gynaecologis

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“…It remains a viable option in patients who wish to preserve their fallopian tubes. Gorry et al ( 39 ) and Watrowski et al ( 40 ) reported cases of primary peritoneal pregnancy and primary omental pregnancy where GTM was used successfully to control bleeding.…”

Section: Introductionmentioning

confidence: 99%

Use of a gelatin-thrombin hemostatic matrix in obstetrics and gynecological surgery

Misirlioğlu

Türkgeldi

Yağmur

et al. 2018

tjod

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Gelatin-thrombin matrix (GTM) is a hemostatic sealant consisting of bovine-derived gelatin matrix and human-derived thrombin, combining both mechanical and active mechanisms to achieve hemostasis. It was approved by the Food and Drug Administration in 1999. GTM has been used by several surgical specialties; however, it is a possibly an under-used tool in obstetrics and gynecology. A limited number of studies have been performed on its use during laparoscopic endometrioma excision and myomectomy. It may prove useful in endometrioma excision in reproductive aged women because it is likely to harm ovarian reserve less than electrocautery; however, this conclusion needs to be validated. The only study on GTM use in myomectomy included 50 women randomized into GTM and control groups, and showed decreased blood loss and shorter hospital stays in the GTM group. In gynecologic oncology, it was successfully used to reduce lymphocele cases in a cohort study. GTM has been used successfully in obstetrics in a handful of cases of uncontrolled bleeding from caesarean scar, placental site, ectopic pregnancy, rectovaginal hematoma, and venous plexus over the vaginal vault after emergency postpartum hysterectomy. Risk of viral transmission is a major concern about GTM, yet there are no reports on disease transmission with GTM use to date. Rare but serious adverse effects and complications have been reported such as fatal or near-fatal thromboembolism and small bowel obstruction. Although GTM is mostly a safe product, it is still not free of complications and risks. In conclusion, although routine use of GTM cannot be recommended due to concerns about its safety, cost, and availability, it may prove useful when conventional hemostatic methods such as suturing and electrocauterization fail or are not appropriate.

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“…[11] It has been used to stop persistent intraoperative bleeding during Caesarean section, [12] in severe postpartum haemorrhage, during gynaecological laparoscopy. [13] It can be used safely in head and neck surgeries without any adverse effects. [14] FloSeal is quite expensive, hence, its use is more logical in major surgical procedures and acute life-threatening haemorrhages.…”

Section: Resultsmentioning

confidence: 99%

Use of gelatin-thrombin matrix haemostatic sealant in neurosurgery: Anaesthetic implications and review of literature

Khanna

Mahajan

Gupta

et al. 2015

Journal of Neuroanaesthesiology and Critical Care

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The topical haemostatic agents have been developed to be used as adjunctive measures to promote haemostasis. These include bone wax, absorbable gel sponges, microfibrillar collagen, oxidised regenerated cellulose, gelatin sponges with thrombin, gelatin-thrombin matrix sealant or fibrin sealants. Gelatin-thrombin matrix sealant is a mixture of a bovine-derived gelatin matrix and human-derived thrombin component that are mixed together at the time of use. This agent has been found to be more effective haemostat than thrombin-soaked gelatine sponges. The possible adverse effects of this can be transmission of diseases from human or bovine sources, allergic reactions, thromboembolism, disseminated intravascular coagulopathy (DIC), perilesional oedema, and compression of neural tissue. Although it is used routinely in the operating room, there is little literature available on the perioperative implications with use of intraoperative gelatin-thrombin matrix sealant. Here, we present clinical report of 20 neurosurgical patients where the sealant was used and literature in view of current evidence has been reviewed.

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Laparoscopic management of abdominal ectopic pregnancy using FLOSEAL Hemostatic Matrix

Cited by 17 publications

References 2 publications

Early abdominal ectopic pregnancy: challenges, update and review of current management

Early abdominal ectopic pregnancy: challenges, update and review of current management

Use of a gelatin-thrombin hemostatic matrix in obstetrics and gynecological surgery

Use of gelatin-thrombin matrix haemostatic sealant in neurosurgery: Anaesthetic implications and review of literature

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