Methods and results

Lowering the risk of haemorrhage may be achieved primarily by proper case selection, resulting in adequate laparoscopic preparation and dissection technique or the use of local compression by sponge stick to control local bleeding. For early bleeding control, laparoscopic clip appliers, staplers and suturing techniques may be utilised. Various energy sources such as monopolar and bipolar electrocautery, argon beam coagulators, laser or ultrasonic dissectors and topical sealing agents can be used to augment natural haemostasis.

Conclusions

A wide armamentarium for achieving haemostasis during laparoscopy is available. Consequently, laparoscopic surgeons must have detailed knowledge of the physical concepts of each surgical instrument or energy source and of proper use of tissue sealants for obtaining sufficient haemostasis. This knowledge will improve postoperative outcome, increase patient safety and guide laparoscopic techniques to further perspectives.

Christoph H. Klingler^a, Mesut Remzi^a, Michael Marberger^a, Gunter Janetschek<sup>b

a</sup> Department of Urology, Medical University of Vienna, Austria
^b Department of Urology, Krankenhaus Elisabethinen Linz, Austria

Accepted 31 January 2006 published online 24 February 2006.