Usefulness of the Adhesion Barrier "AdSpray<sup>®</sup>" in Laparoscopic Surgery

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  • Saito Ryosuke
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Nagayoshi Yoko
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Ueda Kazu
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Hirayama Kana
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Odajima Suguru
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Kasahara Yuta
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Noguchi Daito
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Maruta Takenori
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Kaya Ryusuke
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine
  • Okamoto Aikou
    Department of Obstetrics and Gynecology, The Jikei University School of Medicine

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  • 腹腔鏡手術における癒着防止材アドスプレー<sup>®</sup>の有用性に関する検討

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<p>Objective: Intestinal obstruction and infertility are significant adverse effects related to the formation of postoperative adhesions after gynecological surgery. INTERCEED® (Ethicon) and Seprafilm® (Kaken Pharmaceutical Co., Ltd.) are widely used adsorbable-type adhesion barriers suited for open surgery. However, in December 2016, AdSpray® (Terumo), a spray-type adhesion barrier that allows the insertion of a long nozzle through a trocar, became available for use in Japan. We studied the utility of AdSpray® during laparoscopic surgeries. </p><p>Methods: We studied 37 patients who underwent a total laparoscopic hysterectomy at our hospital between April 2016 and August 2017. Patients were categorized into 2 groups to receive either AdSpray® or INTERCEED®. A retrospective intergroup comparison was performed based on the distribution/adhesion time, white blood cell count, and the C-reactive protein levels on day 1 postoperatively, and the number of days hospitalized after surgery. </p><p>Results: The AdSpray® group showed a shorter distribution/adhesion time than the INTERCEED® group (118 ± 25 s vs. 170 ± 61 s, respectively, p = 0.013). No significant differences were observed in terms of any other outcomes. Neither group showed perioperative complications. </p><p>Conclusion: The tip of the nozzle of AdSpray® can be bent freely to allow passage through the trocar for distribution over uneven surfaces. Thus, AdSpray® is easier and safer to use during laparoscopic surgeries than adsorbable-type adhesion barriers. </p>

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