Small invasive technique of Internal Iliac Artery ligation for postpartum haemorrhage

Objectives: Internal Iliac artery ligation (IIAL) is an effective life-saving method to control obstetric hemorrhage, and a hysterectomy can often be avoided. A standard ligation procedure requires wide tissues dissection: incision in the peritoneum lateral to and parallel with the ureter. That can be traumatic and is difficult in practice what results in a rare use of IIAL in surgical emergency. As an alternative a novel, small invasive technique was used, which protocol is attached to the paper as a video presentation file. Material and methods: Forty-five women treated by Internal Iliac Artery ligation for postpartum haemorrhage. In 27 patients (Cohort A) standard IIAL procedure by Kelly's method was used. In the remaining 18 patients (Cohort B) a novel, small invasive technique was performed. Time of both surgical procedures of IIAL was measured. Results:Time of Standard technique of IIAL vs Novel small invasive technique of IIAL: 34 (26-41) min. vs 13 (8-16) min. p < 0.001. Conclusions: The presented novel small invasive technique of Internal Iliac artery ligation can be an easier and safe alternative for standard ligation procedure.