A simple application technique of fibrin-coated collagen fleece (TachoComb) in laparoscopic surgery.

A fibrin-coated collagen fleece (TachoComb, Nycomed, Denmark) is a powerful topical hemostatic agent, which has been aggressively used in conventional open surgery with a favorable clinical outcome. However, the use of TachoComb in laparoscopic surgery has not yet gained wide clinical acceptance, because a simple and well-functioning application system is not available. The authors have newly developed a quick, simple, and effective laparoscopic TachoComb application technique: housing a small strip of TachoComb in a rubber tube, then conveying it into the peritoneal cavity, and applying it using standard laparoscopic forceps. The repeated application of TachoComb strips is feasible and of practical value especially in laparoscopic surgery, since a small TachoComb never compromises either the application procedure or laparoscopic visualization.