A New Technique for Seprafilm® That Can Be Practiced with a 5-mm Trocar

Abstract

Seprafilm ® is an adhesion barrier sheet. However, it is difficult to handle it through a 5-mm trocar. We have devised a method of applying Seprafilm ® safely and reliably through a 5-mm trocar by using a holder that comes with the film. We practiced this method in three cases of total laparoscopic hysterectomy for uterine leiomyoma. The quarter-pack is cut into three pieces. The film placed on the holder sheet was rolled up with forceps (or wrapped around forceps) and inserted into a 5 mm trocar. After application, the center of the short axis of the holder was pinched with a grasping forceps, and the holder was drawn out of the body through the trocar. Of the 36 pieces placed, Seprafilm ® broke only in once. Insertion was successful in 100%, and the holder was successfully retrieved through the trocar in 92% (33/36) of the cases. The holder may be easily retrieved after application. This technique represents an extremely simple versatile application method in operations in which only 5-mm trocars can be used.

Update on antiadhesion barriers and therapeutics in gynecological surgery

“…An RCT comparing its use to no intervention following laparoscopic myomectomies found no significant difference in incidence of adhesions during second look laparoscopy [42]. Recent reports have been published on techniques for well tolerated and effective use of Seprafilm in laparoscopic surgery involving moistening, rolling and cutting the sheet [43][44][45].…”