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Application of Hemostatic Devices in Laparoscopic Hepatectomy
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How to minimize bleeding in laparoscopic myomectomy.

Priscila Almeida Barbosa1, Marina Villaescusa1, Marina Paula Andres1,2

  • 1Minimally Invasive Gynecological Surgery Program, Hospital BP - A Beneficência Portuguesa de São Paulo.

Current Opinion in Obstetrics & Gynecology
|June 21, 2021
PubMed
Summary

Vasopressin and barbed sutures effectively reduce blood loss during laparoscopic myomectomy. Tranexamic acid (TXA) showed no significant impact, while uterine artery occlusion (UAO) and embolization show promise for bleeding control.

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Surgical Hemostasis

Background:

  • Laparoscopic myomectomy is a standard procedure for symptomatic uterine fibroids.
  • Effective bleeding management is crucial but challenging during this surgery.

Purpose of the Study:

  • To review current evidence on interventions for controlling bleeding during laparoscopic myomectomy.

Main Methods:

  • Review of recent scientific literature on hemostatic techniques.
  • Analysis of studies evaluating vasopressin, barbed sutures, tranexamic acid (TXA), uterine artery occlusion (UAO), and embolization.

Main Results:

  • Vasopressin and barbed sutures significantly decreased blood loss compared to controls.
  • Intraoperative tranexamic acid (TXA) did not demonstrate a significant benefit.
  • Uterine artery occlusion (UAO) and emergency embolization were feasible and potentially reduced bleeding.

Conclusions:

  • Vasopressin and barbed sutures are effective hemostatic agents in laparoscopic myomectomy.
  • TXA is not currently supported by evidence for this indication.
  • UAO and embolization techniques offer potential for bleeding management, warranting further investigation.