Use of human fibrin glue (Tisseel) versus suture during transvaginal natural orifice ovarian cystectomy of benign and non-endometriotic ovarian tumor: a retrospective comparative study

Background To evaluate the use of a human fibrin glue (Tisseel) for minor bleeding control and approximation of ovarian defect during transvaginal natural orifice ovarian cystectomy (TNOOC) of benign and non-endometriotic ovarian tumors. Methods A total of 125 women with benign and non-endometriotic ovarian tumors who underwent TNOOC between May 2011 and January 2020: 54 with the aid of Tisseel and 71 with traditional suture for hemostasis and approximation of ovarian defect. Surgical outcomes such as length of surgery, operative blood loss, postoperative pain score, and postoperative hospital stay were recorded. Before and immediately (10 days) and at 6 months after the procedure, serum anti-Müllerian hormone (AMH) levels were also determined. Results Complete hemostasis and approximation of ovarian defect were achieved in all cases. No significant difference was noted in the operating time, operative blood loss, postoperative pain scores after 12, 24 and 48 h, length of postoperative stay, and baseline AMH levels between the two groups. The operation did not have a negative effect on the immediate and 6-month postoperative AMH levels in the suture group. However, the decline in the AMH levels was significant immediately after surgery in the Tisseel group, nevertheless, no significant difference was noted in the AMH levels at 6 months (3.3 vs. 1.7 mg/mL; p = 0.042, adjusted p = 0.210). Conclusion The use of Tisseel in TNOOC of benign and non-endometriotic ovarian tumors without suturing the ovarian tissue is clinically safe and feasible.

Mesh Fixation in Laparoscopic Inguinal Hernia Repair: Absorbable vs. Non-Absorbable Tacks

Background: Laparoscopic inguinal hernia repair is an accepted technique for the treatment of primary inguinal hernias. There are several ways of mesh fixation including absorbable, non-absorbable staplers and even human fibrin glue. Little evidence is found when looking for a difference in recurrence rates between the first two.

Treating rhinophyma: A case report illustrating decortication/vaporization with an 808-nm diode laser

Rhinophyma is a skin disease that is not only disfiguring but can also have a negative impact on respiratory function by causing nasal obstruction. There is a wide range of techniques used in the surgical management of rhinophyma, including laser treatment, all of which involve tissue ablation. With regard to the laser therapy, there is no consensus as to which laser is most effective. The authors present a case report to illustrate their method of treating rhinophyma with an 808-nm diode laser, which included the use of exogenous pigment to define the target area and the application of human fibrin glue to obtain good hemostasis and wound healing and prevent infection.