A simple and novel technique for the placement of antiadhesive membrane in laparoscopic surgery
Toshihiko Shinohara1, Hideyuki Kashiwagi, Satoru Yanagisawa
1Department of Digestive Surgery, Jikei University School of Medicine, Tokyo, Japan. shinohara@jikei.ac.jp
Abstract:
Laparoscopic surgery is less invasive and allows faster recovery from surgery and reduces postoperative recurrence of adhesions and small bowel obstruction (SBO). However, as much as 30% of patients require repeated treatment for the recurrence of SBO owing to formation of adhesions. To reduce such a complication, we developed a new method on the basis of the use of antiadhesive membrane during laparoscopic surgery. This study included 8 consecutive patients for whom laparoscopic surgery was performed, and antiadhesive membrane was placed intraperitoneally over the wound areas using our new technique. After the median follow-up period of over 3 years, recurrence of SBO has not been observed in any of the patients. Laparoscopic surgery requires advanced surgical skills, including the placement of antiadhesive membrane. Our "Seprafilm flag" technique is simple and easy to employ during laparoscopic surgery that allows prevention of postoperative formation of adhesions.
Insights
This study introduces a new laparoscopic surgery technique using an antiadhesive membrane to prevent adhesions and reduce the recurrence of small bowel obstruction (SBO). The method showed no SBO recurrence in patients after a 3-year follow-up.
Area of Science:
- Minimally Invasive Surgery
- Surgical Adhesion Prevention
- Gastrointestinal Surgery
Background:
- Laparoscopic surgery offers benefits like faster recovery but carries a risk of adhesions, leading to recurrent small bowel obstruction (SBO) in up to 30% of patients.
- Adhesion formation post-laparoscopic surgery is a significant clinical challenge, necessitating strategies to mitigate this complication.
- Current management of recurrent SBO often involves further surgical interventions, highlighting the need for preventative measures.
Purpose of the Study:
- To evaluate the efficacy of a novel technique using an antiadhesive membrane during laparoscopic surgery for preventing postoperative adhesions.
- To assess the recurrence rate of small bowel obstruction (SBO) following the implementation of this new antiadhesion strategy.
- To demonstrate a simple and effective method for placing antiadhesive membranes during laparoscopic procedures.
Main Methods:
- A new technique involving the intraperitoneal placement of an antiadhesive membrane over wound areas during laparoscopic surgery was developed.
- Eight consecutive patients undergoing laparoscopic surgery were included in the study, with the antiadhesive membrane applied using the novel technique.
- The study involved a median follow-up period exceeding 3 years to monitor for SBO recurrence.
Main Results:
- No recurrence of small bowel obstruction (SBO) was observed in any of the 8 patients during the median follow-up period of over 3 years.
- The developed "Seprafilm flag" technique facilitated the placement of the antiadhesive membrane during laparoscopic surgery.
- The technique proved to be simple and easy to employ, aiding in the prevention of postoperative adhesion formation.
Conclusions:
- The novel "Seprafilm flag" technique for applying antiadhesive membranes during laparoscopic surgery is effective in preventing the recurrence of small bowel obstruction (SBO).
- This technique offers a simple and reproducible method for surgeons to reduce postoperative adhesion formation, a common complication of laparoscopic procedures.
- The findings suggest a promising approach to improve long-term outcomes for patients undergoing laparoscopic surgery by minimizing adhesion-related morbidity.
