Usefulness of Moistening Seprafilm Before Use in Laparoscopic Surgery

Izumi, Kouji; Suganuma, Izumi; Ito, Fumihiko; Akiyama, Makoto; Sasaki, Aya; Yamanaka, Kaoruko; Tazaki, Hiroshi; Kitawaki, Jo

doi:10.1097/sle.0b013e31828f6ec1

Cited by 19 publications

(23 citation statements)

References 6 publications

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“…Third, after placing the first piece of Seprafilm, the surgeon can move the second layer to cover additional areas. Our application successful rate of Seprafilm is 95.7% versus the 80% reported in Kusuki et al 11 …”

Section: Discussioncontrasting

confidence: 60%

“…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. However, these 2 methods still do not fully eliminate the drawbacks mentioned above.…”

Section: Discussionmentioning

confidence: 99%

“…6 Several techniques of insertion of Seprafilm have been developed, 7–10 but some require special equipment and some are complicated. 11 Moreover, Seprafilm placement in single-port surgery is more difficult than in multiport surgery.…”

Section: Introductionmentioning

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: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…The prevention of BO is also an inevitable problem in laparoscopic surgery. Some studies have described a method of positioning Seprafilm in laparoscopic surgery to prevent BO and peritoneal adhesion [25][26][27] . However, reports concerning the usefulness of Seprafilm in laparoscopic surgery are few 28) .…”

Section: Introductionmentioning

confidence: 99%

Absorptive anti-adhesion barrier for the prevention of bowel obstruction after laparoscopic colorectal cancer surgery

Fujii

Tsukamoto

Shimada

et al. 2018

J Anus Rectum Colon

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Abstract:Objectives: The protective efficacy of an absorptive adhesion prevention product (Seprafilm ) against bowel obstruction (BO) during open surgery was demonstrated in a large-scale randomized controlled clinical trial in Europe and America. However, the efficacy of Seprafilm against BO in laparoscopic surgery remains uncertain. The objective of this study was to clarify the protective efficacy of Seprafilm against BO after laparoscopic surgery for colorectal cancer. Methods: From 2009 to 2016, 1328 laparoscopic colorectal resections were performed for colorectal cancer. From 2009, Seprafilm was used for preventing BO in laparoscopic colorectal surgery. The incidence of BO and short-term results were compared between the Seprafilm and non-Seprafilm groups after propensity score matching. Results: Propensity scoring generated 270 matched patients per group for the comparisons between the Seprafilm and non-Seprafilm groups. The two groups showed no significant differences regarding patients' backgrounds. Among all patients, 73.1% (19/26) of BO occurred within 30 days after the surgery. Significantly lower incidences of all grade (2.6% vs. 7.0%; p = 0.016) and grade 2 + 3a (1.5% vs. 5.2%; p = 0.017) BO were observed in the Seprafilm group than in the non-Seprafilm group; no significant difference regarding grade 3b BO (1.1% vs. 1.9%; p = 0.476) was found. A significant difference in BO within 30 days was also noted between the two groups (1.9% vs. 5.2%, p = 0.036). There were no significant differences between the groups regarding anastomotic leakage and deep surgical site infection. Conclusions: Seprafilm was useful for preventing BO, requiring decompression therapy of the bowel, after laparoscopic colorectal surgery without increasing adverse events.

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