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Application of Hemostatic Devices in Laparoscopic Hepatectomy
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[Local and systemic hemostasis in surgery]

W O Bechstein1, C Strey

  • 1Klinik für Allgemein- und Gefässchirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, 60590 Frankfurt am Main. wolf.bechstein@kgu.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|January 24, 2007
PubMed

Surgery inevitably leads to bleeding, and hemostasis aims at reducing the amount of blood loss and the need for transfusion as well as preventing rebleeding, hematoma formation, and the need for repeat surgery. Various locally applicable agents are in use including bone wax, gelatin, collagen, oxidized regenerated cellulose, fibrin sealant glues, and synthetic glues. Some evidence from randomized controlled trials (RCT) exists regarding the use of fibrin sealants on their own or combined with collagen fleece. Systemic hemostasis may be achieved with lysine analogs such as epsilon-aminocaproic acid or tranexamic acid and aprotinin, which are inhibitors of fibrinolysis. There is much albeit sometimes conflicting evidence from RCT regarding the use of these substances in surgery. The role of recombinant activated factor VII in achieving systemic hemostasis is being investigated.

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