Yutaka Kojima, MD, Kazuhiro Sakamoto, Professor, Yuichi Tomiki, MD, Michitoshi Goto, MD, Makoto Takahashi, MD, Hirohiko Kamiyama, MD, Kiichi Sugimoto, MD, Shun Ishiyama, MD, Koichiro Niwa, MD, Masaya Kawai, MD, Ryoichi Tsukamoto, MD, Shunsuke Motegi, MD, Yurika Makino, MD, Toshiaki Hagiwara, MD, Seiji Kawasaki, Professor, Yoshiaki Kajiyama, Professor, Tetsu Fukunaga, Professor. Juntendo University Faculty of Medicine
Introduction: Laparoscopic surgery has spread worldwide and become a standard procedure among many abdominal surgical fields. The incidence of postoperative adhesion, which is a typical postoperative complication, is considered low compared with that after laparotomy, but once complications develop, such as adhesion-induced intestinal obstruction and chronic abdominal pain, the low-invasiveness of laparoscopic surgery may decrease markedly. While we have previously used a sheet-type absorbable barrier to prevent adhesion, it requires a technique in many cases when it is applied in the abdominal cavity. In this study, we used a spray-type absorbable barrier, which is considered simple to apply, as an adhesion-preventing absorbable barrier following laparoscopic surgery.
Subjects and Methods: A spray-type absorbable barrier for prevention of adhesion (Ad Spray type L®) was applied to the dissected surface, port region, and beneath the small incised wound in 5 patients who underwent laparoscopic surgery of the large intestine after February 2017. The nozzle is long (334 mm in length) and the angle of the tip is adjustable to some extent, so that the spray could be applied easily to the target region, even in areas in which it would be difficult to secure a work space, by rotating the shaft and finely adjusting the angle of the tip. In order for the barrier to remain in the target region, this preparation must remain viscous after application.
Discussion: Approaches for the insertion and affixing of a conventional sheet-type absorbable barrier for the prevention of adhesion has been reported previously by various researchers. The adhesion-preventing absorbable barrier used in this study was a spray type with a long nozzle, which may have been useful because it made the laparoscopic application easy. However, its application requires some experience and time for preparation compared with the use of the sheet type, which could be disadvantageous. Further accumulation of cases, including evaluation of prevention of adhesion after use of the adhesion-preventing absorbable barrier may be necessary.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86646
Program Number: P494
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster