Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy

Abstract

Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue. Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy. Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.

The efficacy of a thrombin-based hemostatic agent in primary total knee arthroplasty: a meta-analysis

“…Thrombin-based hemostatic agents have come out nearly 15 years and were widely used in surgical procedure including gynecology, general surgery, and orthopedics which were still attracting the attention and interest of multitudinous surgeons. Clapp M [ 7 ] found Floseal® can achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. Testini M [ 8 ] considered that Floseal® was an effective additional agent compared with conventional hemostatic procedures in thyroid surgery.…”

Use of a gelatin-thrombin hemostatic matrix in obstetrics and gynecological surgery

“…Although most tubal pregnancies are managed successfully with salpingectomy or salpingostomy, additional measures may be required to control bleeding. Clapp and Huang ( 37 ) reported two cases of tubal ectopic pregnancies where electrocautery failed to achieve hemostasis and GTM was used successfully. Interestingly, Watrowski ( 38 ) reported two cases of tubal pregnancies managed through salpingostomy where they used only GTM for hemostasis.…”

Cytologic findings following intraoperative use of FlosealR hemostatic matrix: A potential diagnostic pitfall in fluid aspiration cytology

“…Its efficacy has been reported in numerous studies [1][2][3][4][5] with rare reports of adverse side effects such as anaphylactic reactions 6 and acute cerebral edema 7 following intraoperative application. Its utility in the management of a number of conditions such as epistaxis, 8 ectopic pregnancy, [9][10][11][12] and intractable hematuria 13 has also been described. In gynecological oncology surgery, it is of particular utility in the intraoperative treatment of bleeding in lymphadenectomy areas and it has also proven effective in the prevention of lymphoceles in this setting.…”