Management of presacral bleeding
Introduction and hypothesis
The objective of this video is to demonstrate a variety of available techniques that can be used in the management of acute presacral bleeding.
In this video, we demonstrate different methods for the management of presacral bleeding utilizing a fresh frozen cadaver.
Presacral bleeding is a potentially catastrophic complication that can be encountered during pelvic surgery, particularly sacrocolpopexy. Various techniques exist to achieve hemostasis in the event of uncontrolled bleeding. This video demonstrates some of the available methods that may be employed in the management of presacral bleeding. The methods demonstrated in this video include direct pressure, pelvic packing, gelatin matrix, bone wax, thumb tack, surgical clip, suture, oxidized regenerated cellulose, omental flap, electrocautery, muscle fragment welding, gelatin matrix combined with thrombin, and microporous polysaccharide spheres.
Familiarity with these techniques and product availability will aid in the management of acute presacral bleeding.
KeywordsPresacral bleeding Pelvic surgery Simulation
Compliance with ethical standards
Conflicts of interest
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
(MP4 97153 kb)