Laparoscopic Application of Interceed (TC7) in the Pig

Interceed (TC7) is an absorbable barrier that has been shown to be efficacious in reducing postoperative adhesions in animal models and in a human clinical trial. In these studies, Interceed (TC7) was applied at the time of laparotomy. However, increasingly more operative procedures are being performed at laparoscopy. Because of the concern that postoperative adhesion development would limit pregnancy outcome following these laparoscopic procedures, we evaluated the possibility of placement of Interceed (TC7) laparoscopically. Trials were conducted in anesthetized pigs using a three-puncture approach. Small pieces (<1 × 2 cm) of Interceed (TC7) were able to be pushed through a 5 mm second puncture probe, although larger pieces could not be introduced in this fashion. Larger pieces (up to 5 × 7 cm) were introduced as follows. The operating laparoscope was removed from the trocar, a grasping instrument was placed through the operating channel, the material was grasped, the Interceed (TC7) was drawn into the operating channel of the laparoscope, the laparoscope was reintroduced into the abdominal cavity, and the grasping probe was extended through the operating channel. The Interceed (TC7) could then be grasped by instruments introduced through the second puncture sheaths. The material was manipulated to cover parietal and visceral peritoneal surfaces. Once in place, the material was moistened, and it remained in place without suturing. We conclude that it is feasible to consider clinical application of Interceed (TC7) as a part of operative laparoscopic procedures.