A novel technique to apply a Seprafilm (hyaluronate-carboxymethylcellulose) barrier following laparoscopic surgeries.
OBJECTIVE
To describe a novel technique for application of a Seprafilm (modified hyaluronate-carboxymethylcellulose) barrier laparoscopically, and to assess the adequacy of coverage of desired sites.


METHODS
Retrospective cohort study.


METHODS
University tertiary hospital.


METHODS
One hundred twenty-seven patients who underwent fertility-sparing laparoscopic surgery.


METHODS
The Seprafilm was rolled up in a plastic package, then delivered through the main trocar. It was unrolled and positioned to cover the traumatized surface of the uterus, ovaries, and tubes. During application, the pelvis was photographed, videotaped, and the pictures were reviewed by two surgeons.


METHODS
The adequacy of the application was divided into three levels as to whether the Seprafilm could cover all the traumatized surfaces.


RESULTS
Of the first 15 patients, 4 of 15 (26%) had successful coverage of the traumatized surface with the first sheet of Seprafilm. Of the following 112 patients, 97 of 112 (86.5%) had successful coverage with the first sheet. The success rate climbed to 96% after the second or third sheet. The average time for the application of six pieces (one sheet cut into six pieces) was 21 +/- 4 minutes. The posterior cul-de-sac is difficult to apply well.


CONCLUSIONS
It is feasible to apply the antiadhesion barrier Seprafilm laparoscopically. Further studies will be needed to assess the efficacy of reducing adhesion following such use.
Chuang
Yi-Chen
YC
Department of Obstetrics and Gynecology, E-DA Hospital, Kaohsiung, Taiwan. yichen.chuang@gmail.com
Fan
Chun-Nan
CN
Cho
Fu-Nan
FN
Kan
Yuan-Yee
YY
Chang
Yu-Hsiang
YH
Kang
Hong-Yo
HY
D000291:Adnexal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D000328:Adult; D001672:Biocompatible Materials; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D006820:Hyaluronic Acid; D010535:Laparoscopy / Q000009:adverse effects; D008567:Membranes, Artificial; D012189:Retrospective Studies; D000267:Tissue Adhesions; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D055815:Young Adult
D001672:Biocompatible Materials; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid