What is Interceed

If it were not for talking to other women, I could not share with you many important things that have happened to other women, nor how it changes their lives. Yesterday I posted a blog about Seprafilm and the fact there are lawsuits on this product. Then I remembered a young woman I had tried to help about eighteen months ago after she had pelvic pain and struggled to get her records because they told her they couldn’t find them. She contacted me because at that time she wondered if they put mesh in, when she had a C-Section. She is a young mother raising young children and the pain is constant and she has never found out why. I gave her the blog link about Medical Records Law, and she kept pursuing until she did get them because she finally made the hospital tell her where her records were stored. Once she got her operative report, she found out the only thing that was used was Interceed. At that time I could find nothing on this product to help her, so she did make a trip to see Dr. Raz and had the translabial ultrasound done, where it did not show any mesh. He did tell her to have an MRI done and send him the results.

Yesterday I suddenly remembered her and sent her a note to look at her operative report because I remembered they did use something but I could not remember what. This morning I did remember what it was and I began researching about Interceed. Once again there are lawsuits on this one as well. So I searched until I found a really good paper written on these scar tissue barriers and I took some of it to post on this blog. There is a lot more and there are other barrier products, so please read the entire post of which I will give you the link at the end.

“Ninety-three percent of patients who have abdominal surgery will have adhesions,” according to Togas Tulandi, MD, Professor of Obstetrics and Gynecology, The Milton Leong Chair in Reproductive Medicine, McGill University, Montreal. “Adhesions cause infertility, pain, and bowel obstruction,” he explained.

The National Hospital Discharge Survey of hospitalizations between 1998 and 2002 found that out of 281,982 hospitalizations, 51,100 were related to adhesions and adhesions were one of the problems for 227,882 other hospitalizations. Altogether, adhesions were directly or indirectly responsible for 948,000 hospital days, costing $1.18 billion (U.S.).

Another financial consideration is intestinal injury during adhesiolysis. One study found that 52 out of 270 patients had inadvertent injury during adhesiolysis. Risk is related to body mass index and the number of operations. “More injury occurs because of previous abdominal and pelvic surgery,” Dr. Tulandi said.

“There is an association between infertility and adhesions,” he continued. He described research he conducted to test whether removing adhesions would enable women to get pregnant faster. If a patient was not able to achieve pregnancy within one year, Dr. Tulandi would do laparoscopic surgery to remove adhesions. He found that women who had adhesions removed got pregnant faster than those who had adhesions that were not removed.

Pain is another critical aspect of pelvic adhesions. He described an old study that looked at pain in patients who had stage IV adhesions, local adhesions, or adhesions that had been removed. The study found that there was much greater reduction of pain in the group with stage IV adhesions that had been removed.

Small bowel obstruction is another critical aspect of adhesions. “Post-surgical adhesion is the most common cause of bowel obstruction,” Dr. Tulandi said. Within one year following surgery, 1% of patients with adhesions develop bowel obstruction. He explained that gynecologists rarely see patients with bowel obstruction because it can occur years after the initial surgery. When symptoms occur, the patients usually go to the emergency room or to a general surgeon. He added that there is a slightly higher risk of small bowel obstruction in patients who underwent peritoneal closure. “Peritoneal closure is unnecessary and can be harmful,” said Dr. Tulandi.

The most commonly used adhesion prevention method, which is not approved by the FDA, is hydroflotation using crystalloid solutions such as lactated Ringer’s solution or saline. However, “hydroflotation does not work because of the rapid rate of absorption,” explained Dr. diZerega. He listed several studies that have all shown that crystalloids do not prevent adhesions.

There are three devices approved by the FDA for adhesion prevention: the site-specific Interceed® and Seprafilm®, and the broad-covering Intergel®. These devices are FDA-approved for laparotomy use. “There are no approved devices in the United States for adhesion prevention by a laparoscopic instillation,” Dr. diZerega said. Numerous studies have demonstrated the effectiveness of these adhesion prevention devices. More and more physicians, both gynecologists and general surgeons, are utilizing these devices on a routine basis.

Seprafilm® is a site-specific device that is made out of hyaluronic acid and carboxymethylcellulose, and it achieves good results, according to Dr. diZerega. Seprafilm® is very tacky and surgeons must hold the film in its special packaging. The surgeon needs to make sure that the field is dry and easily accessible. Applying Seprafilm® to the posterior pelvis is very challenging. “Studies have provided compelling evidence that Seprafilm® works,” he said.

Interceed® is made of oxidized regenerated cellulose. It is the same material as Surgicel; however, Interceed® lasts longer in the peritoneal cavity. Dr. diZerega reviewed six studies on the efficacy of Interceed®. The results of the studies were fairly consistent and showed that Interceed® is twice as good at preventing adhesions as surgical technique alone. He cited a study by Sawada and colleagues in which patients in a general infertility practice who received Interceed® became pregnant more frequently than the surgical controls (J Repro Med. 2000;45(5):387-9).

Dr. diZerega said that there are two problems with Interceed® that compromise efficacy. First, Interceed® turns black when placed on bleeding tissue because hemoglobin has touched the oxidized cellulose. If a spot of black appears, it is not of concern. However, if the spot enlarges, Interceed® should be removed and better hemostasis established. The second problem is related to the presence of residual irrigation fluid. In the Trendelenburg position, the excess fluid goes into the upper abdomen. Once the patient is out of this position, the excess fluid flows down into the cul-de-sac and washes off the Interceed® (or Seprafilm®). “This is a very major consideration in using this technology,” said Dr. diZerega. He recommended that, when using these site-specific barriers, the patient be placed in reverse Trendelenburg and the fluid in the cul-de-sac removed until there is less than 10 milliliters remaining.

Intergel®, the most recently approved adhesion prevention device, is made of hyaluronic acid, iron, and water. Hyaluronic acid is naturally found in the human body — it fills the eye chamber and is used routinely in ophthalmologic procedures. The hyaluronic acid molecule is absorbed very quickly across the peritoneal membrane. Read more here

There are many abdominal surgeries including keyhole surgeries as well as C-Sections, so if you know someone who has had problems ever since their surgery, please share this blog with them, because they need answers as to why they live in pain. The following is an article written by a surgeon and it has photos of how these barriers are used. I took part of it to explain more but I don’t like to share these phots as I know some people cannot stand the sight of open wounds. So if you have any pelvic pain and had a surgery done, but never felt well since, then please read everything and view how these other surgeries are done. Knowledge is power.

What Is a Laparoscopic Myomectomy?

Laparoscopic surgery is usually performed as out-patient surgery under general anesthesia and has absolutely revolutionized gynecologic surgery because of the short hospital stay and quick recovery. The laparoscope is a slender telescope that is inserted through the navel to view the pelvic and abdominal organs. Two or three small, half-inch incisions are made below the pubic hairline and instruments are passed through these small incisions to perform the surgery. Because the incisions are smaller, patients can enjoy faster recovery times and smaller scars.

Laparoscopic surgery differs from traditional surgery in a few key ways: during laparoscopic surgery, the surgeon is not looking into the abdomen directly through a large incision across the abdomen, but performs the surgery while looking at a large video monitor suspended over the patient’s abdomen.  The surgery, and especially the suturing of the uterus that is necessary during a laparoscopic myomectomy, requires a great deal of hand-eye coordination and dexterity, as well as knowledge of pelvic anatomy in order to be successful.

Can Adhesion Barriers Prevent Scar Tissue?

Another new advance in surgery has been the use of special substances, called adhesion barriers, which help prevent the formation of scar tissue after surgery. Small sheets of cloth-like material can be wrapped around the raw areas from surgery and the material prevents nearby tissue such as the intestines from sticking to the surgery sites. After a few weeks, the material dissolves, leaving the newly healed surgery sites fairly free of adhesions. While the barriers are not perfect, they have been shown to help reduce the formation of adhesions. Read about this here

I found a lawsuit for this product
Once again there are statutes of limitation which usually begins at the time you found out what your problem was.

If you want to learn more about Seprafilm read the blog I wrote yesterday

To know more about getting your records, read this one

19 Comments

  1. Faith Simbeck

    I had surgery to remove my adhesions in October 2015. When the doc when in, he was horrified because most all of my organs below my lungs were stuck to eachother. My bladder was completely entombed and could not stretch, leaving me going to the bathroom about every 10 min or so. The doctor removed everything and instead of using 1 or 2 sheets of barrier, he used 3. Since my surgery I have had cramps so painfully bad on a daily basis. He told me he thought I needed to see a gastrointestinal do . So I went and they could find anything wron and said everything looked great. What I dint understand is why my doc thinks I’m crazy!?!?
    Before my surgery I had to endure 8 mos of terrible pain. My doc said it was my back, so I went and got cortisone shots. I still had the pain. He took my pain medication away from me and realky didn’t want to do anything for me. Am I crazy?? The cramps are unbearable.
    I am not sure if he used Seprafilm or Interceed.

    Reply
    1. Linda (Post author)

      Faith you are NOT crazy, but there could be something else. Don’t go to this doctor, instead go to the hospital where the surgery was performed and get your records. Both operative report and operative nursing notes and it is there you will find what was used. However I think you have another problem anyway, because by removing ‘everything’ it sounds to me like he did a hysterectomy and when he did that, he must have used a bladder sling and/or other mesh. All of this will be in your HOSPITAL records. If you find any of this, please REPORT it to the FDA site. It is easy to do.

      Reply
  2. Kristen

    Adhesions to the bladder do not cause urinary frequency. I would recommend you see a urologist or urogynecologist because this sounds like interstitial cystitis which is a chronic bladder condition that causes pelvic pain. I had 4 surgeries including a hysterectomy that did nothing for my pain (probably even made it worse). Once I was diagnosed with IC, I was able to get the right treatment and I am doing better. I have good days and bad days still but at least I know it is not “all in my head” like so many doctors had told me before!

    Reply
    1. Doreen

      Kristen i have had IC, ENDO and many other things for over 20 years and adhesions DO create additional issues creating problems with urination, frequency and PAIN. The person needs lysis of adhesions, a dr that knows how to excise ENdo and a hydrodistension to look for IC and to break the adhesions also. Do not let anyone tell you adhesions don’t hurt or that they don’t cause any issues. Once I had mine removed it was a world of difference but I am also covered in Hunners Lesions as well.

      Reply
  3. Betty L.

    I have never participated in a blog, but I came here looking for answers and wonder if there are others out there like me. I have had multiple abdominal surgeries since 14 years old when I suffered a gunshot wound to the abdomen. At 32 I had a partial hysterectomy due to a grapefruit size uterine fibroid. Over the years I have had lap gallbladder, and inguinal hernia repair. In December 2015 I went to surgery for my 4th laparoscopic release and take down of adhesions. I was getting through about 5 years of increasing pain with constipation until it was just unbearable then I would have the surgery. My GYN is a very good doctor who was dedicated to taking his time with the surgery to remove the scar tissue instead of just slicing and releasing them, which the first general surgeon did (the adhesions were back in 8 months as bad as ever), so my GYN’s extra time to perform a more focused surgery on the next two, gave me about 5-6 years before I had to return to surgery. In December 2015, he told me there was a product called Interceed that he could place after the removal of the adhesions. He said it would dissolve over the following month of placement but during it’s placement it would keep the scar tissue from immediately growing outward and incasing the bowel again, so the choice was mine to make. He told me he had not seen a great deal of postop problems from the product but since it is relatively new, there was not a lot of clinical data on long term side effects. Having lived a lifetime of miserable abdominal pain, constipation and repeated surgeries, I opted to try the Interceed. At first, I was fine. I thought, wow! I can actually have bowel movements like normal people do! About 5 months postop, I noticed I was having frequent loose bowel movements, especially right after a meal. Then about 7 months postop, I began to feel abdominal pain in the same area, similar to what I felt before the surgery with the pull of the adhesions, and the bowel movements and cramping continued to get worse. In December 2016, 1 year postop, I had become completely unable to go out and eat because of cramping bile that could not be held after eating a meal. Tomorrow will be May 1, 2017 – nearly 1.5 years after surgery and I am nearly home bound. Having managed a physician practice for over 20 years, I expected to get another job when my physician retired at the end of 2016 but I find I can’t commute on the interstate because of the sudden onset of cramping that required immediate access to a bathroom. The doctor I worked for and all my supporting staff knew of the problem I had developed and they were all very supportive. I was permitted to adjust my hours to avoid rush hour traffic and I had access to the restroom whenever the issue arose. I am trying to develop a business I can work from my home office, but it takes a lot of time to acquire clients. One thing is certain, I cannot accept a job more than 10 minutes from my house and I can’t get through an interview. Stress only brings on the symptoms. Does anyone know if there could be any connection to the Interceed? Having had the surgery 3 times before and never, did I have cramping and diarrhea after nearly all meals, I can’t help but wonder if this is the cause, but I sure would like to know!!! And, is there anything that can be done to get this under control??? Any meds? I eat a banana & Activia for breakfast and this generally stays in but I can’t live on these two foods. I take Phillips probiotics daily too. I don’t know what else to do but I miss living life. I hate living in the bathroom and the fear that comes with driving or riding in a car. I have always been a very active person but I can’t even go to the park and walk my dog without fear of “where’s the bathroom?”. I have had two major incidents where I did not get to a bathroom and the humiliation is more than I’m willing to risk, so I just stay home. I may be experiencing some depression, because I am wondering if this is what the rest of my life will be like (at 61 years old). My husband is supportive and sympathetic but I know he misses our old life too (we loved to travel but that’s out now) and I feel sad about it being my fault. I’m short & petite and am putting on weight because I am not active and I feel tired all the time, how can I be tired when I can’t go out and do anything? I do know, but if anyone else has had this issue after Interceed, can you please tell me what you did to correct it?

    Reply
    1. Linda (Post author)

      Betty I spent some time trying to research your symptoms, but it seems little was done to study these products, in the human body. I am going to give you some links to read, but if I were you, I would contact a lawyer and ask them. I hope you can find a way to feel better, but sadly some products cause more pain than they help.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303068 This is a study
      I would also go to the FDA site and report your symptoms. Dr. Raz at UCLA once told me that if you didn’t have it before the surgery, then it is the mesh. I think this will apply with Interceed and by reporting, it will make them aware. More than likely it has happened to others. This is the link. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/detail.cfm?mdrfoi__id=1373738
      This is what Interceed is made of. Modified Cellulose as a Food Additive, Pill Binder or Laxative. Cellulose extracted from wood pulp or cotton and chemically processed with acids or alkali can be added as a creaming agent or thickener to shredded cheese (parmesan), ice cream, fast food (burgers), powdered drink mixes and other commercial foods.

      A lot of people are having reactions from cellulose, which is part of Interseed. https://stopthethyroidmadness.com/2010/05/08/cellulose-is-a-problem-with-desiccated-thyroid/

      http://peopleof.oureverydaylife.com/side-effects-microcrystalline-cellulose-5368.html

      Reply
      1. Betty Lane

        Thank you Linda. Sorry it has taken me so long to find my way back to this link. After my PET scan on Dec 18, I will post the findings, especially if they find anything in the pelvic and abdominal cavity where the Interceed was placed.

        Reply
        1. Linda (Post author)

          No worry Betty. I understand completely.

          Reply
      2. Betty Lane

        Linda, now that I have reconnected with this link, I was able to read, research and follow your advice offerings. I have submitted my report to the FDA. I have read the links your provided. I was FLOORED to see one of the later links states a finding in adverse lung function, as I have just had an incidental finding of a R nodular lung cavity on a chest CT. Naturally, we have been assuming it’s going to be lung cancer, but now I have hopes this is from the Interceed (cellulose absorption). The Pulmonologist I saw Tuesday says it’s characteristics and placement are not overly common with malignant lung masses but more like scarring in someone who has had TB, although I was tested and do not have inactive TB or other symptoms, so that has been ruled out. The size of the nodular cavity did increase a little since a CTA noted it on 2-8-18. Hopefully the PET scan I am having 12-18-18 will help with further diagnosis but I simply cannot thank you enough for your research links. I simply cannot thank you enough for having this blog for people like me who have experienced adverse complications after these Cellulose type mesh implants!!!!

        Reply
        1. Linda (Post author)

          Betty, I am glad you found some of the information very helpful, but sad you are going through so much. I just hope you will be okay and your family is supportive.

          Reply
          1. Betty L

            Hi Linda, I just wanted to update you and anyone else who reads this blog. The pathology on the nodule in my lung turned out to be lung cancer. I had the upper right lobe removed 1-26-19. It’s been a long miserable recovery. They tell me they cannot detect any spread to lymph nodes or other organs at this time. I just had my first follow up CT scan. My oncologist tells me he does not want to use the term “cancer free” because lung cancer is very aggressive and will likely recur. After I got through the 5 month miserable recovery, I am on 2 inhalers daily among other things. Since I’m not a smoker, I will always wonder if the Interceed caused this. I reported to Ethicon but they want a mountain of documentation I just don’t feel like gathering for them. I’m back to work full time, even though it’s a major struggle. I can’t retire until I’m 66 & 2 months. Hope I make it! I saw a new PCP today and she is interested in looking into this further (fired the one who missed this incidental finding. Fortunately the Dr. I work for found it in time, no oncology treatments are needed for now. I’m trying to go back and find the link you sent me with a abstract that stated “We are not terribly happy to learn cellulose can invade the lungs” or something like that. There’s a lot of data here to comb through. If you could re-post that link for me, I’d really appreciate it. I’m glad to have a Dr. who cares enough to dig deeper. I still have the diarrhea but it’s controlled most days with “Colestipol” which is actually a cholesterol drug, but hey! Whatever works! Thank YOU so very much for providing the info you have!

          2. Linda (Post author)

            Betty L I will try to find the right link and give it to you here. It may take a while though as there is so many blogs and research I have done over 9 years. Just know that I do care very much. XX

          3. Linda (Post author)

            Betty L I cannot find that link, but this explains types of lung cancer. Maybe you can glean something from it. https://oddlygrateful.com/lung-cancer-knowledge-base/

    2. Camille Woodard

      Betty,
      I too had Interceed put in Aug 2016 after my Laparoscopic Surgery to remove Endo, adhesions and a right Ovarian Remnant.
      My OB NEVER mentioned putting in an adhesion barrier and didn’t even know it was put in until I read my post operative report.
      I questioned my OB about this being put in without she and I even discussing it. Her response was that she had put it in many patients during surgery and had never had any issues or complaints from past patients about it.
      I’ve looked through ALL my paperwork too and it said nothing about even the possibility that this Interceed would be put in for any reason. I mean do doctors now have the right to put something in a patient’s body without going over it at the pre-op appt? I feel I should have had the option to be able to look into this barrier so that I could have researched it to see if it was something I would want to begin with. This was my 7th Lap surgery, 1st Excision surgery and never had I had an adhesion barrier placed in my body until last year.
      My concern since the surgery has been because of the same symptoms you described having after having Interceed put in. The stomach cramping, nausea & diarrhea after eating is continuous. I had a Colonoscopy 4 weeks prior to my Lap surgery and I got a clean report, no polyps, no issues seen at all in the GI tract. So, like you I have to wonder if this is due to the Interceed?
      Curious if yours has gotten better, worse and what have the doctors said about it your issues since?
      TIA

      Reply
      1. Linda (Post author)

        Camille, sadly they can do anything they want without discussing it with us before the surgery. I didn’t have this product, but the other women here did.

        Reply
  4. Lauren DeAngelo

    I am 1.5 months post op from laparascopic endometriosis removal and just started having similar symptoms 6 days ago. I started having sudden diarrhea and cramping, but don’t feel sick at all. I thought maybe it was a supplement (primrose oil capsule) that I started taking about 1 week prior. I stopped taking that a few days ago and the diarrhea persists. It occurs about 6-13x a day, especially right after eating. I had 3 pieces of intercede placed during my lap surgery and was not informed or told by my surgeon. He records a video of all his surgeries and gives it to you on a USB to view, so this is how I learned about the interceed.
    I felt ok the day after surgery, but on day 2 I developed a fever and severe pain to palpation/rebound. I saw my surgeon and he had me admitted to the hospital for 3 days eith IV antibiotics and I got better. I havent had any problems between then and now. Could this be the interceed?

    Reply
    1. Linda (Post author)

      Lauren I m not a doctor, but to know what the symptoms are, Google Interseed lawsuits and you will read on lawyers sites what they are. you can also email and ask more questions.

      Reply
  5. Betty Lane

    Do to a computer crash, I had lost my link to this site and just found it again. I am so grateful to all of you ladies who have responded to my post. With my 20+ years experience in healthcare management, I acquired a position with an endocrinologist where I can work remotely, performing credentialing, contracting, and overseeing problems their billing service cannot resolve. I decided to see her (the Dr.) as a patient to see if she could help me. She immediately prescribed Colestipol 1 gm, take one – two daily. This is a huge pill and if left out of it’s bottle, it will absorb moisture from the surrounding air and open up, exposing a “fan” type material. This medication is mostly for control of high cholesterol, but in my case, it manages to absorb the excess bile my body is not properly absorbing. It is a huge help in managing my diarrhea so I can go out now. If I forget to take it, I will indeed have the bile diarrhea, so I have set Alexa to remind me to take it every day at noon. I still have diarrhea if I get stuck in sitting still traffic from fear of not having access to a restroom, but this pill does allow me more freedom than I was getting. I still have the abdominal loud gurgling after I eat. I have suffered massive hair loss during this time and have bald patches that supplements do not help (I’m guessing this is because I don’t get proper nutrient absorption from my food before it runs through me). I still have the frequent abdominal ache (about 2 inches to the right of my umbilicus) but at least the bile diarrhea is 90% controlled with this pill.
    Now, for the bad news: I had a heart scare in Feb 2018 that sent me to the ER. They did a CTA of the chest and it revealed an incidental finding of a spot on my right lung. They did not tell me this, just that there was no blood clot in the lung, which is what they were looking for. I saw a cardiologist the next day and have seen my PCP for normal follow up, both did not mention the lung issue that recommended a follow up CT in 3 months. I did see the endocrinologist I work for, in October, asking her if she can find the cause of the bile diarrhea. She asked me to bring any test results I have had so she would not repeat anything. She ordered 12 lab tests on stool samples and some blood work that all came out normal, so nothing INSIDE, such as bacteria is going on. BUT she immediately noticed the CTA incidental finding in the lung and ordered the CT scan. It shows the spot has increased some in size since February’s CTA. I saw a Pulmonologist yesterday. He has concerns for malignancy and ordered a PET scan for further diagnosis. He told me the PET will scan from my shoulders down to my upper thigh area, so FINALLY I will get a scan of my abdomen since the Interceed was placed in Dec 2015. I realize the lung issue is my biggest concern right now, but I’m glad I will also get to see if there is anything going on in my abdominal and pelvic cavity where the Interceed was placed. Thank God for my Endocrinologist who employs me! I will have the PET scan on 12-18-18, and will post again to let you all know what, if anything, is found, after I get the results.

    Reply
  6. Betty Lane

    Hello Ladies, I thought I left an updated post yesterday but I do not see it so I must have clicked something wrong. I lost my link to this site due to a computer crash but went searching for it yesterday. I’m very grateful for the posts Faith, Kristen, Doreen, Camille, and Lauren. It’s comforting to know we are not alone with our postop mesh (Interceed) symptoms. I have much updated info but am going to see if this post appears before I type it again. Thanks for taking the time to share!

    Reply

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