Our Summary

This research paper investigates the factors related to the use of hemostatic agents during traditional laparoscopic or robotic hysterectomies. Hemostatic agents are substances used to stop bleeding during surgery. The study was carried out in a medical center in Cincinnati, OH, and involved reviewing past cases of women who had undergone this type of surgery, some with the use of hemostatic agents and some without.

The results showed that 46% of the cases used a type of hemostatic agent called a fibrin hemostat, 26% used a different type of hemostat, and 28% did not use any hemostat. The type of surgical approach seemed to influence the use of hemostatic agents, with some approaches more likely to use them than others.

However, the study found that the use of hemostatic agents did not seem to have a noticeable effect on the amount of bleeding during surgery. Instead, the factor most strongly linked to the use of hemostatic agents was the identity of the surgeon performing the operation. This suggests that the decision to use hemostatic agents may be more related to individual surgeon’s preference or training rather than a clinical necessity.

FAQs

  1. What are hemostatic agents and how are they used in laparoscopic hysterectomies?
  2. Did the use of hemostatic agents impact the amount of bleeding during surgery according to this study?
  3. What factors influenced the use of hemostatic agents during the surgeries studied?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic hysterectomy is to discuss with their surgeon the use of hemostatic agents during the procedure. They should ask about the potential benefits and risks of using these agents and inquire about the surgeon’s experience and preference regarding their use. It is important for the patient to feel comfortable and informed about all aspects of their surgery to ensure the best possible outcome.

Suitable For

Overall, laparoscopic hysterectomy is typically recommended for patients who have conditions such as uterine fibroids, endometriosis, abnormal uterine bleeding, pelvic pain, or certain types of cancer. Additionally, patients who are looking for a minimally invasive surgical option with shorter recovery time and less scarring may also be good candidates for laparoscopic hysterectomy.

It is important for patients to discuss their individual medical history and condition with their healthcare provider to determine if laparoscopic hysterectomy is the best option for them. Factors such as the size of the uterus, the presence of scar tissue, and the overall health of the patient may also impact the recommendation for laparoscopic hysterectomy.

Timeline

Before laparoscopic hysterectomy:

  1. Patient consultation: The patient meets with their gynecologist to discuss the need for a hysterectomy and the different surgical options available.
  2. Pre-operative tests: The patient undergoes various tests such as blood work, imaging scans, and a physical examination to ensure they are healthy enough for surgery.
  3. Surgical preparation: The patient follows pre-operative instructions, such as fasting before surgery and stopping certain medications that may increase the risk of bleeding.
  4. Anesthesia: The patient is administered anesthesia before the surgery begins.

During laparoscopic hysterectomy:

  1. Small incisions: The surgeon makes small incisions in the abdomen to insert a laparoscope and other surgical instruments.
  2. Removal of the uterus: The surgeon uses the laparoscope to guide the removal of the uterus and possibly other reproductive organs.
  3. Hemostatic agents: If necessary, hemostatic agents may be used to control bleeding during the surgery.
  4. Closure: The incisions are closed with sutures or staples, and the patient is taken to the recovery room.

After laparoscopic hysterectomy:

  1. Recovery: The patient stays in the hospital for a few days to recover from the surgery.
  2. Pain management: The patient is given pain medication to manage any discomfort post-surgery.
  3. Follow-up appointments: The patient follows up with their gynecologist for post-operative care and monitoring.
  4. Return to normal activities: The patient gradually resumes normal activities and may need to avoid heavy lifting and strenuous exercise for a few weeks.
  5. Long-term effects: The patient experiences relief from symptoms that led to the need for a hysterectomy, such as heavy periods or pelvic pain.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hysterectomy include:

  1. What are the benefits of using hemostatic agents during the procedure?
  2. Are there any risks or potential complications associated with the use of hemostatic agents?
  3. How will the decision to use hemostatic agents during my surgery be made?
  4. Are there alternative methods for controlling bleeding during the procedure?
  5. How will the use of hemostatic agents affect my recovery time and post-operative care?
  6. What experience do you have with using hemostatic agents in laparoscopic hysterectomies?
  7. Are there any specific factors about my medical history or condition that may affect the decision to use hemostatic agents?
  8. Will the type of hemostatic agent used during the surgery have any impact on my long-term health or well-being?
  9. Can you provide more information about the different types of hemostatic agents available and their potential benefits or drawbacks?
  10. How will the use of hemostatic agents affect the overall success and outcome of the laparoscopic hysterectomy procedure?

Reference

Authors: Kakos A, Allen V, Whiteside J. Journal: J Minim Invasive Gynecol. 2016 Nov-Dec;23(7):1167-1171. doi: 10.1016/j.jmig.2016.08.827. Epub 2016 Aug 30. PMID: 27590570