Abstract
Presacral bleeding is a dreaded complication of pelvic surgery. Rapid and effective control of such bleeding is important to avoid potentially life-threatening outcomes. Various methods for controlling presacral bleeding, all with only limited success, have been described in the literature. We report the alternative technique of using the argon beam coagulator (ABC) to control presacral bleeding. We demonstrate its efficacious use in both open surgery and a laparoscopic case. Our approach involved applying an argon beam at bone setting directly to the bleeders and using a “point and shoot” technique. We found that ABC is a simpler, equally effective and expeditious way of addressing presacral bleeding. To the best of our knowledge, there has been only one previously reported case in the literature of the use of ABC to control presacral bleeding.
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References
Kandeel A, Meguid A, Hawasli A (2011) Controlling difficult pelvic bleeding with argon beam coagulator during laparoscopic ultra low anterior resection. Surg Laparosc Endosc Percutan Tech 21:E21–E23
Wang QY, Shi WJ, Zhao YR, Zhou WQ, He ZR (1985) New concepts in severe presacral hemorrhage during proctectomy. Arch Surg 120:1013–1020
Papalambros E, Sigala F, Felekouras E et al (2005) Management of massive presacral bleeding during low pelvic surgery—an alternative technique. Zentralbl Chir 130:267–269
Ambra L, Berti S, Bonfante P, Bianchi C, Gianquinto D, Falco E (2009) Hemostatic step-by-step procedure to control presacral bleeding during laparoscopic total mesorectal excision. World J Surg 33:812–815
Zama N, Fazio VW, Jagelman DG, Lavery IC, Weakley FL, Church JM (1988) Efficacy of pelvic packing in maintaining hemostasis after rectal excision of cancer. Dis Colon Rectum 31:923–928
Ayuste E Jr, Roxas MF (2004) Validating the use of rectus muscle fragment welding to control presacral bleeding during rectal mobilization. Asian J Surg 27:18–21
Yu LP, Dai GF, Duan JC, Xu YB, Chen WJ, Zhou LQ (2011) Thin steel plate with thumbtack fixation in the treatment of massive presacral venous plexus hemorrhage. Chin Med J 124:3180–3181
Braley SC, Schneider PD, Bold RJ, Goodnight JE Jr, Khatri VP (2002) Controlled tamponade of severe presacral venous hemorrhage: use of a breast implant sizer. Dis Colon Rectum 45:140–142
Joseph P, Perakath B (2011) Control of presacral venous bleeding with helical tacks on PTFE pledgets combined with pelvic packing. Tech Coloproctol 15:79–80
Germanos S, Bolanis I, Saedon M, Baratsis S (2010) Control of presacral venous bleeding during rectal surgery. Am J Surg 200:E33–E35
Takeda N, Kobayashi T, Tandai S et al (2009) Treatment of giant cell tumors in sacrum and spine with curettage and argon beam coagulator. J Orthop Sci 14:210–214
Stojeba N, Mahoudeau G, Segura P, Meyer C, Steib A (1999) Possible venous argon gas embolism complicating argon gas enhanced coagulation during liver surgery. Acta Anaesthesiol Scand 43:866–867
Ikegami T, Shimada M, Imura S et al (2009) Argon gas embolism in the application of laparoscopic microwave coagulation therapy. J Hepatobiliary Pancreat Surg 16:394–398
Cornejo A, Liao L, Kenneth WW (2010) Argon gas embolism with the use of argon beam coagulation during open hepatic resection. Int J Surg ISSN 2:1528–8242
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Saurabh, S., Strobos, E.H., Patankar, S. et al. The argon beam coagulator: a more effective and expeditious way to address presacral bleeding. Tech Coloproctol 18, 73–76 (2014). https://doi.org/10.1007/s10151-012-0915-5
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DOI: https://doi.org/10.1007/s10151-012-0915-5