Biosurgicals and the Minimally Invasive Gynecologic Surgery (MIGS) Surgeon

Area of Science:

• Surgical Innovation
• Biomaterials Science
• Gynecologic Surgery

Background:

• Biosurgical materials are crucial for hemostasis, particularly when electrocautery, sutures, or clips are not feasible.
• While widely used in general surgery, biosurgicals are underutilized in obstetric and gynecologic procedures.
• Effective hemostasis is critical for patient outcomes in all surgical settings.

Purpose of the Study:

• To review biosurgical products, their composition, and applications in minimally invasive gynecologic surgery (MIGS).
• To highlight the roles of oxidized regenerated cellulose, flowables, and fibrin sealants in MIGS.
• To provide guidance on appropriate use and potential combination strategies for biosurgicals in MIGS.

Main Methods:

• Review of commonly used biosurgical agents: oxidized regenerated cellulose, flowables, and fibrin sealants (including patches).
• Discussion of "on-label" and "off-label" uses of these agents in MIGS.
• Exploration of how these agents can be used individually or in combination for hemostasis management.

Main Results:

• Oxidized regenerated cellulose, flowables, and fibrin sealants offer diverse hemostatic capabilities in MIGS.
• Fibrin sealant patches represent a unique option for managing various bleeding intensities, including severe hemorrhage.
• Understanding the specific properties of each biosurgical agent is key to optimizing their use.

Conclusions:

• Biosurgicals are valuable tools for hemostasis in minimally invasive gynecologic surgery.
• Appropriate selection and application of biosurgicals can enhance surgical outcomes and reduce complications.
• Further integration of biosurgicals into gynecologic practice is warranted.