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Hemostatic step-by-step procedure to control presacral bleeding during laparoscopic total mesorectal excision

, : Hemostatic step-by-step procedure to control presacral bleeding during laparoscopic total mesorectal excision. World Journal of Surgery 33(4): 812-815

A new procedure of hemostasis during laparoscopic total mesorectal excision is described. In our surgical department, from January 2004 to December 2007, 128 patients underwent laparoscopic total mesorectal excision. Among them, 47 patients underwent laparoscopic anterior resection after preoperative radiotherapy, 68 patients underwent laparoscopic anterior resection without preoperative radiotherapy, and 13 patients underwent laparoscopic abdominal perineal amputation. In seven laparoscopic rectal surgery cases, we encountered unstoppable presacral bleeding, not amenable by conventional hemostatic solutions. In these cases we applied a simple staging hemostatic procedure. We first performed local compression: tamponing with a small gauze or absorbable fabric hemostat. If bleeding did not stop, we localized an epiploic or omental scrap and excised it by using bipolar forceps and use it as a plug on the tip of a grasping forceps. This plug is then put on the bleeding source and monopolar coagulation is applied by electrified dissecting forceps through the interposed grasping forceps. If bleeding did not stop, we used a little scrap of bovine pericardium graft and tacked it to the bleeding site using endoscopic helicoidal protack. Our experience suggests that this hemostatic step-by-step procedure is a valid option to control persistent presacral hemorrhages.


PMID: 19093145

DOI: 10.1007/s00268-008-9846-8

Other references

Novikov, V.A.; Altukhova, L.A., 1967: The dynamics of the amino acids of plastid protein during the development of the Diamant variety of spring wheat. Zap Leningrad Sel Skokhoz Inst 90(5): 35-42

Fachner, J., 2002: Topographic EEG changes accompanying cannabis-induced alteration of music perception - cannabis as a hearing aid?. An explorative study on cannabis and music perception is presented, conducted in a qualitative and quantitative way in a habituated setting. EEG-brainmapping data (4 subjects; rest-pre/post listening; 28 EEG traces; smoked cannabis containing 20 m...

Barhart, P., 1968: New battery operated dental engine and turbines. Die Quintessenz 19(9): 117-119

Anonymous, 2011: Neuregulin Sorting Domains. The neuregulins (NRGs) play important roles in animal development and homeostasis, and their deregulation has been linked to diseases such as cancer and schizophrenia. The NRGs belong to the epidermal growth factor (EGF) family of transmembrane gr...

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Shaw, J.M.; Pieringer, R.A., 1977: Glucuronosyl diacylglycerol of Pseudomonas diminuta ATCC 11568. In vitro biosynthesis from UDP-glucuronate and diacylglycerol. The biosynthesis of glucuronosyl diacylglycerol from UDP-glucuronate and diacylglycerol is catalyzed by an enzyme found in both the 34,800 X g supernatant and particulate preparations from disrupted Pseudomonas diminuta (ATCC 11586). UDP-glucurona...

Blunden, S.L.; Beebe, D.W., 2006: The contribution of intermittent hypoxia, sleep debt and sleep disruption to daytime performance deficits in children: consideration of respiratory and non-respiratory sleep disorders. In children, the most abundant available information regarding the effects of paediatric sleep disturbance on daytime function has been obtained by studying children with sleep disordered breathing (SDB). The purported underlying pathophysiologica...

Bremerich, A.; Krischek-Bremerich, P., 1991: Current therapy for trigeminal neuralgia--overview from different considerations of possible dental therapies. Die Quintessenz 42(12): 1893-1900

Lashene, D.G., 1983: Effectiveness of Soviet-produced human somatotropin in the treatment of hypothalamo-pituitary dwarfism. Neuroscience and Behavioral Physiology 13(2): 126-129

Deridder, M., 1995: Psychological effects of hemodialysis. Soins; la Revue de Reference Infirmiere: 32, 34-32, 34