Category: clinical results
SprayShield™ – the new product by Covidien
Since December 2008 we are using the new SprayShield™ by COVIDIEN. SprayGel™ was modified in some parts, so the resorption was promised to be shorter (5-7 days) than it was with SprayGel™(7-14 days). And the blue colour is not due to methylenblue anymore but a simple colour used frequently in food. More components were modified and I should report later in this board. For now I just wanted to show the clinical results. This is a picture of adhesions on the left pelvic wall: and this after adhesiolysis and here after coverage with SprayShield™: and here the beautiful healed result at 2nd look laparoscopy ONLY 5 days later: For clinical comparison here you can see an image with similar adhesions after adhesiolysis and covered with the SprayGel™ and 7 days later in the 2nd look laparoscopy. One can see that the SprayGel™ is still there and a little tissue reaction (reddish areas with neovascularisation) is shown: And again for comparison again with SprayShield™, where after only 5 days, SprayShield™ is fully absorbed and the peritoneum is smooth without any reaction: Actually there seems to be a better and rapid resorption of the Hydrogel and the absence of methylenblue, which was taken from the market some times ago. I think that this result in less foreign body or allergic reactions as in some cases occurred with SprayGel™. We will continue research and if that is the case, we might decrease the time between Surgery and 2nd look laparoscopy to five days, so the time necessary to stay at the hospital will be shorter. Also some complications in regard to infections might decrease with the new product.
Extreme adhesions situs
Lift-Laparoscopy in combination with SprayGel have good results even in the worst cases, where nearly all abdomen is covered with adhesions and the bowel adheres with his wall to the abdominal peritoneum. Adhesions dissection is very dangerous: as bowel might be injured and has to be sutured: Application of SprayGel as adhesions barrier: and at the second look laparoscopy: bowel healed excellent, the sutures close sufficient, no infection or reformation of adhesions:
Another adhesiolysis with SprayShield™
A picture of adhesions on the left pelvic wall: and this after adhesiolysis and here after coverage with SprayShield™: and here the beautiful healed result at 2nd look laparoscopy 7 days later: Again to say this: the SprayShield™ is fully absorbed and the peritoneum is smooth and without any reaction. There are no reddish areas, like with SprayGel™ (see pictures above) and no reaction, the peritoneum is already completely healed.
Another adhesions surgery with SprayShield™
Again a picture of adhesions, here on the right pelvic wall. After an appendectomy the bowel (mid of picture) is completely adherent to the pelvic wall and has to be dissected: and this after adhesiolysis and here after coverage with SprayShield™: and here the beautiful healed result at 2nd look laparoscopy only 5 days later: Also here to see: the SprayShield™ is fully absorbed and the peritoneum is smooth and without any reaction. There are no reddish areas, like with SprayGel™ (see pictures above) and no reaction; the peritoneum is already completely healed. Here one can see the result in a higher magnification: ——————–
Gynecologic adhesiolysis with SprayShield
Most of our adhesions patients are presented with bowel adhesions after open surgeries. Here you can see a case with gynecological adhesions, that cause pain and infertility. Left pelvic area is completely covered with bowel. One can only recognize the apex of the ovary (white) and a small part of the tube: After lift-laparoscopic adhesiolysis the female anatomy can be recognized very well: left ovary and the left tube with the fimbria, bowel in the correct anatomical situation. Application of SprayGel as adhesions barrier… and in the second-look laparoscopy: no reformation or de-novo adhesions occure. See more here
