Modified novel technique for improving the success rate of applying seprafilm by using laparoscopy.
OBJECTIVE
To describe a modified surgical procedure for applying the adhesion barrier Seprafilm laparoscopically.


METHODS
Retrospective analysis with videos and illustrations showing laparoscopic application of Seprafilm.


METHODS
University hospital.


METHODS
Women undergoing fertility-sparing laparoscopic surgery (myomectomy, endometriotic ovarian cyst or dermoid cyst enucleation, and tuboplasty) via a modified technique.


METHODS
Two layers of Seprafilm with plastic covering were rolled together and delivered through a 10-mm trocar, and an irrigation tube was used to moisten the Seprafilm and cover the irregular postoperative rough surface of the organ. After application of Seprafilm, the patient was placed in a reverse Trendelenburg position to check whether the Seprafilm remained in situ on the target surgical surface to act as a physical barrier to adhesion development.


RESULTS
After changing the patient's position, illustrations and videos showed that the Seprafilm remained on the postoperative surgical surface, creating a site-specific physical barrier. On day 4 after myomectomy, second-look laparoscopy in 2 patients showed that the Seprafilm had become gel-like and remained between the intestine and posterior rough surface of the uterus. There were no systemic second-look laparoscopic data.


CONCLUSIONS
It is feasible and easier to apply Seprafilm adhesion barrier laparoscopically using the modified technique. Further studies are warranted to prove its efficacy after such use.
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan. Electronic address: yichen.chuang@gmail.com.
Yi-Chen
YC
Chuang
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan.
Hsin-Fen
HF
Lu
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan.
Fu-Shiang
FS
Peng
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan.
Wan-Hua Stella
WH
Ting
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan.
Fung-Chao
FC
Tu
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan.
Ming-Jer
MJ
Chen
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Yuan's General Hospital, Kaohsiung City, Taiwan.
Yuen-Yee
YY
Kan
D000291:Adnexal Diseases / Q000601:surgery*; D000328:Adult; D001672:Biocompatible Materials; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D006820:Hyaluronic Acid; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000379:methods
D001672:Biocompatible Materials; C118198:Seprafilm; D006820:Hyaluronic Acid
Adhesion; Laparoscopy; Myomectomy; Seprafilm