Fibrin Sealing in Endoscopic Surgery

Abstract

The special merits of fibrin sealing are the possibility of simple atraumatic tissue union and hemostasis and, thus, decreased duration of surgical intervention. This technique is therefore already well established for a number of indications in surgical gynecologic endoscopy. These include, in particular, the reshaping of an ovary after extirpation of a cyst, the application during tubal anastomosis, and the sealing of iatrogenic perforations of the uterus. Unequivocal evidence of the efficacy of fibrin sealing of serous and peritoneal defects with the purpose of adhesion prophylaxis is not yet available. Whereas fibrin sealing due to its good long-term results is regarded as the preferred method for the first-mentioned indications, further studies with a large number of cases and long follow-up are necessary to enable a final evaluation of this technique for the latter indications. No complications were evident in the postoperative course or during follow-up in the 75 laparoscopic fibrin sealings carried out to date. In addition to its wound healing properties, fibrin sealing was found to be intraoperatively superior as the time-consuming endoscopic sutures were replaced in a simple and atraumatic manner; furthermore, a simultaneous hemostyptic action was attained.