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International Urogynecology Journal
Published in: International Urogynecology Journal 1/2020

01-01-2020 | Laparotomy | IUJ Video

Management of presacral bleeding

Authors: Erik D. Hokenstad, John A. Occhino

Published in: International Urogynecology Journal | Issue 1/2020

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Abstract

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.

Methods

In this video, we demonstrate different methods for the management of presacral bleeding utilizing a fresh frozen cadaver.

Results

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.

Conclusion

Familiarity with these techniques and product availability will aid in the management of acute presacral bleeding.
Appendix
Available only for authorised users
Literature
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Gelfoam (absorbable gelatin compressed sponge, USP) [package insert]. Pfizer Pharmacia & Upjohn Co. New York NY; 2012.
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Metadata
Title
Management of presacral bleeding
Authors
Erik D. Hokenstad
John A. Occhino
Publication date
01-01-2020
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 1/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-019-03995-w

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