Laparoscopic repair of inferior vena caval injury using a chitosan-based hemostatic dressing

Hua Xie, Jeffrey S. Teach, Allen P. Burke, Lisa D. Lucchesi, Ping Cheng Wu, Rebecca C. Sarao

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Vena caval injury is a rare but serious complication of laparoscopic surgery, and often requires conversion to an open procedure. The current study investigated whether a vena caval injury could be repaired with a chitosan dressing laparoscopically. Methods: Six domestic swine were studied. A 4- to 5-mm circumferential incision was created in the inferior vena cava (IVC) and repaired laparoscopically with a chitosan dressing. Neither suture nor additional hemostatic techniques were used. The animals were killed at 30 minutes (n = 2) and at 1 week (n = 4) postoperatively for histopathological analysis. Results: All IVC injuries were successfully repaired laparoscopically using a single chitosan dressing application without recurrent hemorrhaging. Mean operative time was 6 minutes and the blood loss was approximately 55 mL. There was no evidence of clot formation in the repaired vessels. Histology showed that the chitosan dressing had partially degenerated into small particles with moderate chronic inflammatory response 1 week after repair. Conclusion: Use of the chitosan-based hemostatic dressing is a simple and reliable technique to control serious hemorrhage from IVC injury during laparoscopic surgery.

Original languageEnglish (US)
Pages (from-to)510-514
Number of pages5
JournalAmerican Journal of Surgery
Volume197
Issue number4
DOIs
StatePublished - Apr 2009

Fingerprint

Venae Cavae
Chitosan
Hemostatics
Bandages
Inferior Vena Cava
Wounds and Injuries
Laparoscopy
Hemostatic Techniques
Conversion to Open Surgery
Operative Time
Sutures
Histology
Swine
Hemorrhage

Keywords

  • Animal model
  • Inferior vena cava
  • Injury
  • Laparoscopic

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic repair of inferior vena caval injury using a chitosan-based hemostatic dressing. / Xie, Hua; Teach, Jeffrey S.; Burke, Allen P.; Lucchesi, Lisa D.; Wu, Ping Cheng; Sarao, Rebecca C.

In: American Journal of Surgery, Vol. 197, No. 4, 04.2009, p. 510-514.

Research output: Contribution to journalArticle

Xie, Hua ; Teach, Jeffrey S. ; Burke, Allen P. ; Lucchesi, Lisa D. ; Wu, Ping Cheng ; Sarao, Rebecca C. / Laparoscopic repair of inferior vena caval injury using a chitosan-based hemostatic dressing. In: American Journal of Surgery. 2009 ; Vol. 197, No. 4. pp. 510-514.
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