A method for inserting an adhesion barrier (Seprafilm^®) via a 5-mm trocar

Abstract

Objective: Prevention of adhesions is important after a surgery. Although a sodium hyaluronate- and carboxymethylcellulose-based membrane is useful as an adhesion barrier, its properties make it difficult to insert into the abdominal cavity. We developed a method for inserting a sodium hyaluronate- and carboxymethylcellulose-based membrane into the abdominal cavity via a 5-mm trocar.

Methods: Each sodium hyaluronate- and carboxymethylcellulose-based membrane sheet (total 2 sheets) was cut into 8 pieces. Two pieces were moistened using steam, with one piece on placed top of another over a thermos bottle. The sodium hyaluronate- and carboxymethylcellulose-based membrane pieces were rolled around a forceps and inserted into the abdominal cavity via a 5-mm trocar. This method was used in 10 cases (8 times per case, total 80 times).

Results: The average time required for inserting the sodium hyaluronate- and carboxymethylcellulose-based membrane pieces (8 times) was 333 seconds (250 seconds–434 seconds). The success rate of insertion and attachment of the membrane was 92.5% (74 / 80). In 6 cases, failure occurred at the step of spreading the rolled up pieces after inserting them into the abdominal cavity.

Conclusions: This new method is effective for inserting sodium hyaluronate- and carboxymethylcellulose-based membranes into the abdominal cavity without requiring special tools.