Rafał Watrowski1. 1. Department of Gynecology and Obstetrics, St. Josefskrankenhaus, Teaching Hospital of the University of Freiburg, Sautierstr. 1, 79100, Freiburg, Germany, Rafal.Watrowski@gmx.at.
Abstract
PURPOSE: Laparoscopic salpingotomy has become the gold standard for the treatment of tubal ectopic pregnancy (TEP). Limitations for organ preservation in TEP can result from intra-operative bleeding or potential tubal damage due to application of thermal coagulation. Hemostatic gelatine-thrombin matrix Floseal® allows effective local hemostasis when sutures or thermal coagulation are inadequate or impossible. METHODS: We demonstrate in two cases how tubal preservation following effective hemostasis can be achieved by local application of gelatine-thrombin matrix. RESULTS: In both cases, the ectopic pregnancy was localized in the ampullar part of the right tube, with gestational sac diameter of 38 and 15 mm, respectively, and visible embryos of 25 and 6.5 mm, respectively. After laparoscopic salpingotomy and evacuation of TEP, diffuse bleeding from the implantation site at the tubal wall was treated with the hemostatic matrix. Punctual bipolar coagulation was used only in Case 1 for striking bleeding from incision margins. Both patients were discharged without complications within 24-48 h after operation. CONCLUSIONS: Hemostatic gelatine-thrombin matrix Floseal® minimizes tissue damage and optimizes local hemostasis. The use of Floseal® enhances the chance of organ preservation in the laparoscopic treatment of TEP.
PURPOSE: Laparoscopic salpingotomy has become the gold standard for the treatment of tubal ectopic pregnancy (TEP). Limitations for organ preservation in TEP can result from intra-operative bleeding or potential tubal damage due to application of thermal coagulation. Hemostatic gelatine-thrombin matrix Floseal® allows effective local hemostasis when sutures or thermal coagulation are inadequate or impossible. METHODS: We demonstrate in two cases how tubal preservation following effective hemostasis can be achieved by local application of gelatine-thrombin matrix. RESULTS: In both cases, the ectopic pregnancy was localized in the ampullar part of the right tube, with gestational sac diameter of 38 and 15 mm, respectively, and visible embryos of 25 and 6.5 mm, respectively. After laparoscopic salpingotomy and evacuation of TEP, diffuse bleeding from the implantation site at the tubal wall was treated with the hemostatic matrix. Punctual bipolar coagulation was used only in Case 1 for striking bleeding from incision margins. Both patients were discharged without complications within 24-48 h after operation. CONCLUSIONS: Hemostatic gelatine-thrombin matrix Floseal® minimizes tissue damage and optimizes local hemostasis. The use of Floseal® enhances the chance of organ preservation in the laparoscopic treatment of TEP.