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The use of novel hemostatic sealant (Tisseel®) in laparoscopic myomectomy: a case–control study

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Abstract

Background

This is the first case–control study on the use of a fibrin sealant (Tisseel®) on uterine suture during laparoscopic myomectomy (LM), with the primary endpoint to evaluate the intraoperative bleeding and postoperative blood loss. In addition, we evaluated the time required to achieve hemostasis using Tisseel® and how much it can influence operative time.

Methods

From December 2009 to January 2011, consecutive patients older than 18 years with symptomatic isolate intramural myoma with maximal diameter ≤6 cm and ≥4 cm and with a sonographically diagnosed free myometrium margin ≥0.5 cm were included in the study. We selected from our institute’s database a group of consecutive patients with homogeneous features of the study group, who underwent laparoscopic myomectomy without Tisseel® application.

Results

Fifteen women with symptomatic myoma were enrolled in the study (group A). Regarding the control group (group B), we selected a homogenous group of 15 patients with the same preoperative characteristics of the study group. Mean operative time was 47.7 min and 62.1 min, for groups A and B respectively (p < 0.05). Mean time required to achieve complete haemostasis was 195.5 s in group A and 361.8 in control group B (p < 0.0001). Mean estimated blood loss was 111.3 mL and 230 mL in groups A and B, respectively (p < 0.05). Mean hemoglobin decrease was 1.36 g/dL and 2.04 g/dL in groups A and B, respectively (p < 0.05).

Conclusions

The use of Tisseel® during LM may represent a valid alternative solution for obtaining hemostasis, reducing intra- and postoperative bleeding. Furthermore, it may help the surgeon to obtain a rapid healing of the injured surfaces, probably reducing the use of electrocoagulation and traumatisms.

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Disclosures

Drs. Roberto Angioli, Francesco Plotti, Roberto Ricciardi, Corrado Terranova, Marzio Angelo Zullo, Patrizio Damiani, Roberto Montera, Federica Guzzo, Giuseppe Scaletta, and Ludovico Muzii have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, “Campus Bio Medico” University of Rome, Via Álvaro del Portillo, 200-00128, Rome, Italy

    Roberto Angioli, Francesco Plotti, Roberto Ricciardi, Corrado Terranova, Marzio Angelo Zullo, Patrizio Damiani, Roberto Montera, Federica Guzzo, Giuseppe Scaletta & Ludovico Muzii

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  1. Roberto Angioli
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  2. Francesco Plotti
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Correspondence to Roberto Angioli.

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Angioli, R., Plotti, F., Ricciardi, R. et al. The use of novel hemostatic sealant (Tisseel®) in laparoscopic myomectomy: a case–control study. Surg Endosc 26, 2046–2053 (2012). https://doi.org/10.1007/s00464-012-2154-2

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