Gynecologic Surgery and Internal Scarring

If you’re going to have a hysterectomy or other open gynecologic (pelvic) surgery, you should know about adhesions – internal scars that can form between tissues and organs after surgery. Adhesions are common following open pelvic surgery including myomectomy (fibroid removal), hysterectomy, surgery for endometriosis, C-section, and operations on the fallopian tubes and ovaries.¹ Pelvic surgery is frequently part of the treatment for ovarian cancer, cervical cancer, and endometrial or uterine cancer.

Post-surgical adhesions can lead to a number of complications, including

• Infertility¹
• Bowel obstruction²
• Chronic pelvic pain³
• Complications during future surgeries⁴
• Difficulties with future treatments, including laparoscopy⁵, IP chemotherapy⁵, and radiotherapy⁶

Reducing Adhesions with SEPRAFILM®

Doctors use a number of techniques to help prevent adhesions.  One way is using SEPRAFILM Adhesion Barrier. SEPRAFILM is a clear, reabsorbable film that’s applied during open surgery. It separates organs and body tissues from one another, helping to prevent them from attaching as they heal. SEPRAFILM stays in place during the critical seven-day healing period⁷, and is then absorbed naturally by your body.⁸

SEPRAFILM is safe and effective in open pelvic surgery.

• In a study of patients undergoing radical pelvic surgery (removal of the ovaries, fallopian tubes and uterus), patients who received SEPRAFILM had 69% fewer pelvic floor adhesions than patients who did not receive an adhesion barrier.³ 
• In a study of patients receiving SEPRAFILM at open myomectomy, SEPRAFILM reduced the incidence, severity, and extent of uterine adhesions.⁹
• In a study of patients receiving SEPRAFILM at primary C-section, SEPRAFILM significantly reduced adhesions, resulting in decreased procedure and delivery times at repeat C-section.¹⁰

  If you’re going to have open pelvic surgery, ask your doctor if SEPRAFILM may be right for you.

Adhesions Internal scars that may form after surgery on or between internal organs and/or body tissue. Adhesions between tissues can twist and pull organs out of their normal places. Full glossary

Endometriosis The formation or growth of endometrial tissue (tissue in the inner layer of the uterine wall) in places other than the uterus. This tissue frequently forms cysts. Full glossary

Myomectomy The surgical removal of a myoma. A myoma is a tumor consisting of muscle tissue. Full glossary

Fallopian Tube Either of the pair of tubes that carry the eggs from the ovary to the uterus—also called the uterine tubes Full glossary

Ovaries Female reproductive organs that produce eggs and female sex hormones. Full glossary

Fibroids Benign/non-cancerous growths in, on, or within the walls of the uterus. Full glossary

Uterus A female reproductive organ for containing and providing nourishment to a fetus during development prior to birth (often referred to as the womb). Full glossary

Cesarean Section A surgical procedure in which your OB/GYN makes an incision through your lower abdomen and then through your uterus in order to access and deliver your baby. An alternative to vaginal birth when indicated by an OB/GYN. Full glossary

Hysterectomy Surgical removal of the uterus. Full glossary

1. DiZerega GS.  Peritoneal repair and postsurgical adhesion formation. In: Management of Common Problems in Obstetrics & Gynecology. Mishell DR, Goodwin Murphy T, Brenner PF, eds. Malden, MA: Blackwell Publishing; 2002: 267-271.

 

1. DiZerega GS.  Peritoneal repair and postsurgical adhesion formation. In: Management of Common Problems in Obstetrics & Gynecology. Mishell DR, Goodwin Murphy T, Brenner PF, eds. Malden, MA: Blackwell Publishing; 2002: 267-271.

 

2. Ellis H, Moran B, et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet. 1999;353(9163):1476-1480.

 

3. Bristow RE, Montz FJ. Prevention of adhesion formation after radical oophorectomy using a sodium hyaluronate-carboxymethylcellulose (HA-CMC) barrier. Gynecol Oncol. 2005;99:301-308.

 

3. Bristow RE, Montz FJ. Prevention of adhesion formation after radical oophorectomy using a sodium hyaluronate-carboxymethylcellulose (HA-CMC) barrier. Gynecol Oncol. 2005;99:301-308.

 

4. Van der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, Reijnen MMPJ, Schaapveld M, van Goor H.  Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg. 2000;87(4):467-471.

 

5. Nichols DH, Clarke-Pearson DL, eds. Gynecologic, Obstetric, and Related Surgery. 2^nd ed. St. Louis, MO: Mosby, Inc; 1993.

 

5. Nichols DH, Clarke-Pearson DL, eds. Gynecologic, Obstetric, and Related Surgery. 2^nd ed. St. Louis, MO: Mosby, Inc; 1993.

 

6. Eifel PF.  Radiation therapy. In: Berek JS, Hacker NF, eds. Practical Gynecologic Oncology, 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005: 119-161.

 

7. Raftery AT. Regeneration of parietal and visceral peritoneum: an electron microscopical study. J Anat. 1973;115:375-392.

 

8. SEPRAFILM Prescribing Information. Cambridge, MA: Genzyme Biosurgery; 2007

 

9. Diamond MP. Reduction of adhesions after uterine myomectomy by Seprafilm membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Fert Steril 1996; 66(6);904-910.

 

10. Fushiki H, Ikoma T, Kobayashi H, Yoshimoto H. Efficacy of SEPRAFILM as an Adhesion Barrier in Cesarean Sections. Obstetric and Gynecological Treatment [Japanese]. 2005;91(5):557-561.