Steps:
- A compression test is first performed using lap sponges to verify that
tamponade compression will be effective. Compression should be
continued until balloon tamponade is ready for insertion.
- Under sterile conditions, two catheters are passed into a latex glove.
The opening of the glove is secured by a silk suture tied around the
catheters’ stems. One catheter is connected to a manual air-pump and
the other to a sphygmomanometer.
- Under general anesthesia, the glove tamponade is inflated and
positioned into the pelvis, whereas the lap sponges are carefully
removed. An intra-pelvic (IP) drain is inserted, and the partially
inflated glove is further inflated to fill the pelvic cavity (Fig. 1).
- The glove tamponade is pressed against the pelvic wall by an assistant
and the abdominal wall is closed by the primary surgeon. The abdomen
is closed carefully – avoiding puncture of the glove - while the
catheters’ stems and the ligature is kept outside the skin.
- A multilayered gauze dressing is applied to the abdominal incision
together with 2-3 lap sponges to support the incision line. A broad
adhesive tape is applied over the dressing, followed by an abdominal
binder to stabilize the tamponade in place (Fig. 2). Inflation
continues until no bleeding is observed in the drain. Pneumatic
pressure is monitored using the sphygmomanometer.
- Initial deflation test is initiated 24 hours after procedure with
observation of IP drain output. The glove is removed, at bedside
without anesthesia, 24 hours after deflation and persistent
hemostasis.