Microfibrillar collagen hemostat during laparoscopically directed liver biopsy

Meticulous hemostasis is a necessity during laparoscopic procedures in maintaining a clear visual field and avoiding the need for an extended laparotomy to secure hemostasis. Methods of hemostasis available to laparoscopic surgeons include direct pressure, suture/clip ligation, conventional monopolar or argon-enhanced coagulation, and application of topical hemostatic agents. The effectiveness of topical hemostatic agents for open surgical procedures has been demonstrated; however, to date, laparoscopic utilization of topical hemostatic agents has been hampered by lack of compatible forms for laparoscopic instillation. Endo-Avitene is a 15 x 50 mm rolled sheet of microfibrillar collagen hemostat, available in an applicator capable of placement through standard laparoscopic trocar. The use of Endo-Avitene during laparoscopically-directed liver biopsies in a porcine model is reported. The effective hemostatic properties of microfibrillar collagen hemostat were reaffirmed and the clinical utility of Endo-Avitene for laparoscopic use is demonstrated.