Modified Novel Technique for Improving the Success Rate of Applying Seprafilm by Using Laparoscopy

Chuang, Yung Chun; Lu, Hsin-Fen; Peng, Fu-Shiang; Ting, Wan-Hua; Tu, Fung-Chao; Chen, Ming-jer; Kan, Yuen-Yee

doi:10.1016/j.jmig.2014.02.016

Cited by 20 publications

(14 citation statements)

References 5 publications

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“…The average time of placing Seprafilm in this study was below 5 minutes, less time than reported in the 2 recent studies mentioned earlier (8 minutes 12 and 10 minutes 11 ). The time reduction is probably due to easier entry and ease of distinguishing the Seprafilm from the backing paper.…”

Section: Discussioncontrasting

confidence: 69%

“…Chuang et al 12 proposed the use of 2 layers of Seprafilm so that it does not stick to the plastic covering, facilitating the removal of the second layer of film from the placement site. Kusuki et al 11 suggested moistening the Seprafilm before introducing it into the abdomen cavity by opening the valves of a 12-mm trocar and using no holder.…”

Section: Discussionmentioning

confidence: 99%

“…This proposed method is a better method that combines and simplifies the two previously reported methods. 11,12 …”

Section: Introductionmentioning

confidence: 99%

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Seprafilm® Application Method in Laparoscopic Surgery

Hong

Ding

2017

JSLS

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Background and Objectives:Postoperative adhesions occur less often in laparoscopies than in laparotomies, but the incidence can be reduced further. Seprafilm, a sodium hyaluronate/carboxymethylcellulose absorbable barrier, was developed to prevent adhesions after abdominal surgery, and is approved for postoperative adhesion prevention. However, Seprafilm is seldom used in laparoscopic surgery because of its tendency to break apart when it is inserted into the abdominal cavity through a trocar, resulting in a high placement failure rate. We propose a better method for applying the adhesion barrier Seprafilm in single- or multiport gynecologic surgery.Methods:This is a retrospective analysis of patients who underwent multi- or single-port gynecologic laparoscopies from December 2014 through January 2016 in Buddhist Tzu Chi General Hospital, Hualien, 46 patients received Seprafilm (Genzyme Corp., Cambridge, MA, USA) via the proposed method. A piece of Seprafilm was cut into quarters. To moisten and soften the Seprafilm, each piece was placed on a wet wrung gauze until it became naturally curled. Two pieces of the film were rolled up with the backing paper that came from the package of Seprafilm. Holding the rolled Seprafilm with a grasper, the surgeon delivered it into the abdomen through a 11-mm trocar.Results:The success rates of Seprafilm insertion and correct placement were 100% (46/46) and 95.7%, respectively. In 2 single-port (2/26) laparoscopic surgeries, the placement of the film failed; all placements in the multiport laparoscopic surgeries were successful (20/20). The average time required for placement of pieces of Seprafilm per surgery was 4.0 ± 1.47 minutes among all surgeries; significantly more time was needed in the single-port surgeries (mean, 4.4 ± 1.59 minutes) than in the multiport surgery (mean, 3.4 ± 1.13 minutes) (P < .05).Conclusions:This method of Seprafilm placement is a simple technique that does not need special equipment and ensures a high success rate. The placement of the film takes longer in single-port surgeries than in multiport surgeries.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Seprafilm® Application Method in Laparoscopic Surgery

Hong

Ding

2017

JSLS

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“…Recently, Chuang et al . proposed using two layers of Seprafilm so that it does not stick to the plastic covering; this also facilitates the removal of the second layer of film from the placement site . However, with our method we were able to use the top three layers without moisture or stickiness.…”

Section: Discussionmentioning

confidence: 99%

Safe and easy technique for the laparoscopic application of Seprafilm® in gynecologic surgery

Ota

Sakai

Ogasawara

et al. 2018

Asian J Endoscop Surgery

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Introduction Laparoscopic surgery is a minimally invasive surgery, and the rate of postoperative adhesions is low. Although Seprafilm® helps to reduce adhesions, its application in the abdominal cavity during laparoscopic surgery is difficult because of its material. Therefore, we propose an easy method for applying this adhesion barrier. Materials and Surgical Technique The Seprafilm is cut into four equal pieces. The four pieces are stacked, firmly folded twice, and grasped with the forceps. The reducer sleeve is slid over the bundle of Seprafilm. The forceps with the reducer sleeve is inserted through a 12‐mm trocar near the target area. The reducer sleeve is then slid down the forceps to uncover the Seprafilm. Finally, each piece of Seprafilm is applied over the suture area. In all cases, the Seprafilm was successfully applied to the intended target. There were no cases in which Seprafilm was incompletely applied or in which it could not be used because of moistening. The average application times of surgeon 1 and surgeon 2 were 4.8 min and 5.0 min, respectively; this difference was not significant. There were no postoperative complications in any case. Discussion It is safe and easy to use our simple technique to apply Seprafilm adhesion barrier laparoscopically. Further studies are warranted to prove Seprafilm's efficacy after such application.

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“…However, Seprafilm is seldom used in laparoscopic surgery because it easily breaks and sticks[32]. We applied a simple technique (using wet gauze and paper roll) for rapid and safe placement of Seprafilm onto the surgical sites[33].…”

Section: Discussionmentioning

confidence: 99%

Robotic single-site supracervical hysterectomy with manual morcellation: Preliminary experience

Ding

Hong

Chu

et al. 2017

WJCC

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AIMTo evaluate the feasibility, safety and peri- and postoperative outcomes of robotic single-site supracervical hysterectomy (RSSSH) for benign gynecologic disease.METHODSWe report 3 patients who received RSSSH for adenomyosis of the uterus from November 2015 to April 2016. We evaluated the feasibility, safety and outcomes among these patients.RESULTSThe mean surgical time was 244 min and the estimated blood loss was 216 mL, with no blood transfusion necessitated. The docking time was shortened gradually from 30 to 10 min. We spent 148 min on console operation. Manual morcellation time was also short, ranging from 5 to 10 min. The mean hospital stay was 5 d. Lower VAS pain score was also noted. There is no complication during or after surgery.CONCLUSIONRSSSH is feasible and safe, incurs less postoperative pain and gives good cosmetic appearance. The technique of in-bag, manual morcellation can avoid tumor dissemination.

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Modified Novel Technique for Improving the Success Rate of Applying Seprafilm by Using Laparoscopy

Cited by 20 publications

References 5 publications

Seprafilm® Application Method in Laparoscopic Surgery

Seprafilm® Application Method in Laparoscopic Surgery

Safe and easy technique for the laparoscopic application of Seprafilm® in gynecologic surgery

Robotic single-site supracervical hysterectomy with manual morcellation: Preliminary experience

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