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Laparoscopic Adhesion Prophylaxis After Myomectomy

Kraemer, Wallwiener M., Brochhausen, Planck, Hierlemann, Isaacson, Rajab, Wallwiener C.

August 3, 2017
Emma Holt

Unpacking Medical Terms

In this pilot study from 2010, authors Kraemer, Wallwiener M., Brochhausen, Planck, Hierlemann, Isaacson, Rajab, and Wallwiener C. studied laparoscopic adhesion prophylaxis after myomectomy. First of all, it’s important to note that laparoscopic surgery is a surgery that allows doctors to look at the abdominal organs or the female pelvic organs through a thin, lighted tube or telescope called a laparoscope. This surgery is used to find problems such as cysts, infections, fibroids, or in this case, adhesions. I’m sure you’re already familiar with the term adhesion which is a scar tissue that binds together two parts of your tissue not usually joined together. Finally, prophylaxis is the action taken to prevent a disease. So, we’re looking patients who underwent laparoscopic myomectomy - the surgical removal of fibroids from the uterus, and comparing it with icodextrin. All you need to know about icodextrin is it’s used after gynecological laparoscopic surgery for the reduction of post-surgical adhesions.

The study is done with a copolymer designed for endoscopic application. Endoscopy is a nonsurgical procedure used to examine a person’s digestive tract with a flexible tube with a light and camera attached to it.

‍About the study

Measurements and results 

The randomized, single-blinded study took place in a German University Hospital in 2010 and a total of thirty patients participated. In all but 1 case, complete coverage of the uterine wound was achieved with PCT copolymer and the average time taken for the application was 6.7 minutes. On the other hand, the average application time for icodextrin was just 1.1 minute! The researchers found that after the “introduction into the abdomen,” PCT copolymer changed into a flexible state that adapted well to the operative anatomy. Doctors followed up with the patients for up to three months and saw no unforeseen adverse events, possible adhesion-relation complications, or complications in either study arm. In fact, there were no significant differences in pelvic pain scores between the copolymer and icodextrin groups after the surgery! 

Conclusion & Summary

Now that there was no difference in postoperative pelvic pain, what should be done next? 

In this pilot study, there were no adverse or harmful events and the designed material properties are favorable for laparoscopic application. However, because there was no notable difference between PCT copolymer and icodextrin, a human phase II trial including a second-look laparoscopy may need to occur. This will help further evaluate the new adhesion barrier copolymer. 


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