Topical hemostatic and tissue-sealing agents in gynecologic surgery

Area of Science:

• Gynecologic Surgery
• Surgical Hemostasis
• Medical Device Review

Background:

• Topical hemostatic agents (THAs) are increasingly utilized in various surgical fields.
• Their specific application and impact within gynecologic surgery require further elucidation.
• Understanding THA mechanisms and potential risks is crucial for optimizing patient outcomes.

Purpose of the Study:

• To review the current use of topical hemostatic agents in gynecologic surgery.
• To evaluate the efficacy and safety of THAs in different gynecologic procedures.
• To identify evidence gaps regarding THA use in gynecologic surgery.

Main Methods:

• Systematic review of recent literature on topical hemostatic agents.
• Analysis of studies reporting THA use in hysterectomy, myomectomy, and ovarian cystectomy.
• Assessment of evidence for THA use in benign minimally invasive gynecologic surgery (MIGS).

Main Results:

• THAs demonstrate reduced bleeding and operating room time in hysterectomy for cancer and abdominal myomectomy.
• Ovarian reserve may be negatively impacted by THA use during ovarian cystectomy.
• Significant complications associated with THAs include abscess, obstruction, inflammation, and infection transmission.
• Limited evidence supports THA use in benign MIGS procedures.

Conclusions:

• While THAs offer benefits in specific gynecologic procedures, their application is not universally defined.
• Surgeons must weigh the benefits against potential risks, such as decreased ovarian reserve and complications.
• Further research is needed to establish clear guidelines for THA use in benign gynecologic surgery.