The argon beam coagulator: a more effective and expeditious way to address presacral bleeding

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E. H. Strobos ◽  
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Soichiro Kitamura

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Fangfang Chen ◽  
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Vol 73 (4) ◽  
pp. 410-413 ◽  
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Manolis Leandros ◽  
Kostas Albanopoulos ◽  
Michael Genetzakis ◽  
Emmanuel Lagoudianakis ◽  
...  

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 pre-sacral 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.


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