Simple and Easy Technique for the Placement of Seprafilm During Laparoscopic Surgery

Sumi, Yasuo; Yamashita, Kimihiro; Kanemitsu, Kiyonori; Yamamoto, Masashi; Kanaji, Shingo; Imanishi, Tatsuya; Suzuki, Satoshi; Tanaka, Kenichi; Kakeji, Yoshihiro

doi:10.1007/s12262-015-1220-0

Cited by 11 publications

(6 citation statements)

References 4 publications

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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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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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“…However, the fragile and sticky characteristics of Seprafilm cause many surgeons to hesitate from using it for deep surgical sites, such as the pelvic wall and retroperitoneal surface, with laparoscopic techniques. There have been several studies that introduced different methods for the placement of Seprafilm during laparoscopic surgery, such as grasping and rolling it directly with forceps, 3–5 wrapping it with its backing paper, 6,7 and using an introducer 8–11 . Although those methods are well‐designed and performed placement of Seprafilm with high success rates, some weak points remain.…”

Section: Discussionmentioning

confidence: 99%

“…Second, this method needs no special equipment, except gauze. Some previous reports introduced other methods by using special equipment—introducers such as a reduction sleeve (KARL STORZ GMBH & CO, Tuttlingen, Germany 9,10 ) (Integra, Plainsboro, USA 11 ) or an adhesion prevention sheet introducer (Hakko, Tokyo, Japan 8 ), which are only used for the application of Seprafilm with extra costs. On the other hand, our method requires only gauze, which is generally used for multiple purposes during laparoscopic surgery and has an economical advantage.…”

Section: Discussionmentioning

confidence: 99%

Simple and reliable method for the application of Seprafilm® during laparoscopic surgery

Shimizu

Kuriu

Arita

et al. 2021

Asian J Endoscop Surgery

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Introduction: Seprafilm ® has been used to prevent postoperative adhesion.However, it is challenging to insert and apply Seprafilm during laparoscopic surgery because of its fragility and sticky nature caused by moisture. Some studies have reported how to apply Seprafilm into a surgical site during laparoscopic surgery; however, some required special equipment with additional costs, and some were technically difficult to use. Herein, we introduced our simple method for applying Seprafilm during laparoscopic surgery. Material and Surgical Technique: Seprafilm was cut into three equal rectangle-shaped pieces and left to absorb moisture for a few minutes. All three pieces of Seprafilm were placed on the gauze, and the gauze was folded in half and grasped by forceps. The gauze with Seprafilm was inserted through a

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“…However, with our method we were able to use the top three layers without moisture or stickiness. Additionally, Sumi et al reported that their method with the reducer sleeve could easily overcome the Seprafilm's susceptibility to tearing, which makes it unmanageable to spread out in the abdominal cavity (8). These previous techniques were simple and helpful for surgeons, but they are not widely used.…”

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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Simple and Easy Technique for the Placement of Seprafilm During Laparoscopic Surgery

Cited by 11 publications

References 4 publications

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

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

Simple and reliable method for the application of Seprafilm® during laparoscopic surgery

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

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