Laparoscopic stripping of benigne ovarian cysts without bi-coagulation or sutures using a gelantin-thrombin matrix (FloSeal) – First report of a promising technique

Objective: Laparoscopic surgery has become gold standard for the treatment of benigne symptomatic and/or therapy-resistant ovarian cysts. In praxi, the stripping technique seems to be the mostly used technique in ovarian cyst surgery. After stripping the cystic wall, the consecutive bleeding of the ovarian stromal wound ground will be usually stopped by bi-coagulation or/and by suturing. Therefore, the ovarian tissue damage might be increased by heat or by sutures. Might be FloSeal instillation a safe alternative technique?

Material and Methods: 12 Patients with benigne ovarian cysts underwend laparoscopy for cystic wall removal by stripping technique and FloSeal instillation. Preoperative and postoperative parameters: LH, FSH, E2, P, CRP, CA125, AMH, ultrasound.

Results: Using pre- and postoperative ultrasound incl. Hb/Hkt, no postoperative bleedings have been detected. In addition, no significant changes of LH, FSH, E2, P, CA125, CRP, AMH were detectable.

Conclusion: The use of gelantine-thrombin-matrix might avoid additional ovarian tissue damage, which is of great importance for the ovarian reproductive function in woman. For the first time, we present a promising laparoscopic technique demonstrating ovarian cystectomy without any coagulation and/or suturing of ovarian tissue using a gelantin- thrombin matrix as a new tool to stop post-cystectomy ovarian wound bleeding.

benigne ovarian cysts - laparoscopy - stripping technique - FloSeal