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Chapter-34 Tubal Hemorrhage After Laparoscopic Surgery

BOOK TITLE: Textbook on Complications in Gynecological Surgery

Author
1. Sabnis Aneesh
ISBN
9788180617140
DOI
10.5005/jp/books/10963_34
Edition
1/e
Publishing Year
2006
Pages
10
Author Affiliations
1. Sneh Nursing Home and Centre for Gynecological Endoscopic Surgery, Andheri (E), Mumbai
Chapter keywords
Tubal hemorrhage, Salpingotomy, Hypertension, Persistent ectopic pregnancy, Vasoactive agents, Vasopressin, Prostaglandin F2, Adrenalin and oxytocin, Methotrexate, Aquadissection, Chemical hemostasis, Ferracrylum, Electrosurgery, Laser, Mechanical pressure, Hemostasis, Peritubal adhesions

Abstract

A case history is given, of a woman who had haemorrhage following salpingotomy. It followed sudden post-operative hypertension which persisted for half an hour, leading to opening up of bleeders near the cornu of the tube. The danger of the effect of vasoconstrictors waning off, leading to bleeding is highlighted. Delayed post-operative tubal haemorrhage following persistent ectopic pregnancy, after salpingostomy is highlighted. Preventive measures to avoid tubal haemorrhage are suggested. Use of vasoactive agents like vasopressin, Prostaglandin F2, Adrenalin and Oxytocin and use of methotrexate are described. Surgical techniques like aquadissection, minimal tugging with grasper, avoidance of grasping the tubal mucosal bed, and many others are suggested to avoid bleeding during tubal surgery. Management of tubal haemorrhage with mechanical pressure, chemical hemostasis, Ferracrylum, use of electrosurgery, laser, etc. is described. Delayed post-operative haemorrhage, and means of diagnosing it are described.

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