The use of spray electrocautery to control presacral bleeding : A report of four cases

Bleeding originating from the presacral venous plexus during pelvic operations is difficult to control, constituting a potentially life-threatening complication. Although suture ligatures, packing, and placement of tacks are established hemostatic techniques, they are often proved to be ineffective....

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Bibliographic Details
Published in:The American surgeon 2007-04, Vol.73 (4), p.410-413
Main Authors: FILIPPAKIS, George M, LEANDROS, Manolis, ALBANOPOULOS, Kostas, GENETZAKIS, Michael, LAGOUDIANAKIS, Emmanuel, PARARAS, Nikos, KONSTANDOULAKIS, Manousos M
Format: Article
Language:English
Subjects:
Aged
Back pain
Biological and medical sciences
Digestive System Surgical Procedures - methods
Dissection
Electric currents
Electrocoagulation - methods
Female
Frequencies
General aspects
Hemostasis, Surgical - methods
Humans
Male
Medical sciences
Middle Aged
Miscellaneous
Patients
Public health. Hygiene
Public health. Hygiene-occupational medicine
Rectal Neoplasms - surgery
Surgeons
Tissues
Tumors
Veins & arteries
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Summary:Bleeding originating from the presacral venous plexus during pelvic operations is difficult to control, constituting a potentially life-threatening complication. Although suture ligatures, packing, and placement of tacks are established hemostatic techniques, they are often proved to be ineffective. We report a simple novel technique using spray diathermy for managing this severe complication. We have applied our method in four patients, two undergoing low anterior resection, and the others undergoing abdominoperineal resection for rectal cancer, that manifested severe presacral bleeding during rectal mobilization. Electrocautery at spray setting was applied slightly above the target bleeders at the presacral fascia, delivering a high-frequency electrical current in combination with drainage suction. In all cases, the method resulted in successful hemostasis. Applying spray electrocautery is a simple and effective method for controlling presacral bleeding. The advantages of using such a method instead of conventional hemostatic techniques include the option of varying the degree of haemostatic effect by altering the frequency and the volume of electric current.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313480707300422