Vasopressin as a hemostatic and dissection aid at vaginal hysterectomy

Potter, Timothy; Fletcher, HM; Reid, Marvin

doi:10.1016/j.ijgo.2004.04.011

Cited by 13 publications

(6 citation statements)

References 1 publication

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“…Compared with pure normal saline, vasopressin solution not only reduced the amount of blood loss, but also shortened the operative time in TVH. The operative morbidity did not increase [29]. Two surgical teams working at the same time, while one surgeon or assistant used a lateral intervention method in dorsal lithotomy position there is another surgeon or assistant performing laparoscopic dissection on dense adhesions, can keep bladder injury to a minimum.…”

Section: Discussionmentioning

confidence: 89%

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

et al. 2007

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Section: Discussionmentioning

confidence: 89%

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

et al. 2007

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“…Severe hypertension, myocardial infarction, and acute pulmonary edema have been reported after vasopressin use during surgical procedures. [ 13 ] Sufficient evidence on optimal concentration of vasopressin in relation to bleeding and safety in laparoscopic surgery is lacking. [ 12 ] Conservative surgical management has the potential of persistent ectopic pregnancy (PEP) after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Successful procedure in conservative management of interstitial (cornual) ectopic pregnancy

Pramayadi

Bramantyo

Gunardi

2018

Gynecol Minim Invasive Ther

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A 35-year-old woman presented with spotting and lower abdominal pain. Follow-up sonography was suggestive of interstitial ectopic pregnancy. Laparoscopic cornuostomy was carried out. Before incision, diluted vasopressin was injected around the site of interstitial pregnancy. Removal of the conceptual tissues was conducted smoothly through a 1.5 cm incision. The overall blood loss was 50 mL. The operative time was 50 min, and there were no intraoperative complications. We successfully performed laparoscopic cornuostomy, which was followed by an unremarkable postoperative course. Laparoscopic surgery is a safe and effective minimally invasive surgical intervention for interstitial ectopic pregnancy if performed by the experienced surgeon. Local vasopressin injection is a good alternative for bleeding control in conservative laparoscopic surgery.

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“…Five studies compared intracervical injection of vasopressin with normal saline or no injection at the beginning of vaginal hysterectomy (n5345) with good, 31,32 fair, 33,34 and poor 35 study quality. Compared with women in a control group, vasopressin decreased estimated blood loss by approximately 130 cc with higher postoperative hematocrit (1-2%; moderate-quality evidence); there was no difference in incidence of vaginal cuff infection (moderate-quality evidence), operative time (low-quality evidence), or hospital length of stay (high-quality evidence).…”

Section: Postoperativementioning

confidence: 99%

Comparison of Vaginal Hysterectomy Techniques and Interventions for Benign Indications: A Systematic Review

Jeppson

Balgobin

Rahn

et al. 2017

Obstetrical &Amp; Gynecological Survey

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for the Society of Gynecologic Surgeons Systematic Review Group OBJECTIVE: To create evidence-based clinical practice guidelines based on a systematic review of published literature regarding the risks and benefits of available preoperative, intraoperative, and postoperative technical steps and interventions at the time of vaginal hysterectomy for benign indications. DATA SOURCES:We systematically searched the literature to identify studies that compared technical steps or interventions during the preoperative, intraoperative, and postoperative periods surrounding vaginal hysterectomy. We searched MEDLINE, Cochrane Central Register of Controlled Trials, Health Technology Assessments, and ClinicalTrials.gov from their inception until April 10, 2016, using the MeSH term "Hysterectomy, Vaginal" and associated text words. We included comparative studies, singlegroup studies, and systematic reviews published in English. METHODS OF STUDY SELECTION:We doublescreened 4,250 abstracts, identifying 60 eligible studies. Discrepancies were adjudicated by a third reviewer. We followed standard systematic review methodology and the Grades for Recommendation, Assessment, Development and Evaluation approach to evaluate the evidence and generate guideline recommendations. TABULATION, INTEGRATION, AND RESULTS:Because of limited literature, only 16 perioperative risks, technical steps, and interventions were identified: obesity, large uteri, prior surgery, gonadotropin-releasing hormone agonists, vaginal antisepsis, bilateral salpingooophorectomy, morcellation, apical closure, uterine sealers, hemostatic injectants, hot cone, retractor, cystoscopy, vaginal packing, bladder management, and accustimulation. We organized and reported these as four domains: patient selection, preoperative, intraoperative, and postoperative. We did not identify any patient characteristics precluding a vaginal approach; chlorhexidine or povidone is appropriate for vaginal antisepsis; vasopressin decreases blood loss by 130 cc; tissue-sealing devices decrease blood loss by 44 cc and operative time by 15 minutes with uncertain complication implications; vertical cuff closure results in 1-cm increased vaginal length; either peritoneum or epithelium can be used for colpotomy closure; and routine vaginal packing is not advised.CONCLUSION: Minimal data exist to guide surgeons with respect to planning and performing a vaginal hysterectomy. This study identifies available information and future areas for investigation.

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Vasopressin as a hemostatic and dissection aid at vaginal hysterectomy

Cited by 13 publications

References 1 publication

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

Minimizing bladder injury in laparoscopically assisted vaginal hysterectomy among women with previous cesarean sections

Successful procedure in conservative management of interstitial (cornual) ectopic pregnancy

Comparison of Vaginal Hysterectomy Techniques and Interventions for Benign Indications: A Systematic Review

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