First report of a combined hemostatic technique using Hydrofit® and SURGICEL Absorbable HemostatTM for intraoperative hemorrhage in gynecologic oncology surgery: a video article.

OBJECTIVE

To report the first use of Hydrofit® (Sanyo Chemical Industries, Kyoto, Japan), a polyurethane prepolymer sealant, combined with SURGICEL Absorbable Hemostat™ (Johnson & Johnson MedTech, Somerville, NJ, USA) as an oxidized cellulose carrier, for intraoperative hemorrhage control in gynecologic oncology surgery, with video documentation.

METHODS

Two patients undergoing open gynecologic oncology surgery developed hemorrhage refractory to conventional hemostatic measures. SURGICEL Absorbable Hemostat™ (Johnson & Johnson MedTech) coated with Hydrofit® (Sanyo Chemical Industries) was applied to the bleeding site with 3 minutes of manual compression. Surgical findings and postoperative courses were retrospectively reviewed. Institutional ethics approval and written informed consent were obtained from both patients.

RESULT: Case 1: high-grade serous carcinoma of the fallopian tube with neuroendocrine features; total blood loss 4,439 g. Hemostasis at the resection surface was visually confirmed; the patient was discharged 7 days after surgery. At interval debulking surgery 4 months later, a fibrous mass adherent to the sigmoid colon with foreign body giant cells was noted at the application site; R0 resection was achieved. Case 2: cervical squamous cell carcinoma, International Federation of Gynecology and Obstetrics (2018) stage IIB; total blood loss 886 g. Hemorrhage from the right internal iliac vein was controlled within 3 minutes; the patient was discharged 11 days after surgery.

CONCLUSION

This combined hemostatic technique may serve as an adjunctive option when conventional measures fail during gynecologic oncology surgery. The adhesion formation observed at reoperation warrants caution. Prospective evaluation using site-specific blood loss measurements is required to establish efficacy and safety.