Effect of hyaluron derivate gel in prevention of postsurgical peritoneal adhesions--an experimental study in pigs.
OBJECTIVE
The aim of this study was to assess the efficacy of a hyaluronic acid derivate gel in reducing adhesions in pigs undergoing laparoscopic abdominal cavity surgery.


METHODS
20 domestic female pigs underwent laparoscopy in general anesthesia. 4 defined serosal defects have been made (hepatoduodenal ligament, parietal, anterior stomach wall and jejunal mesentery). The defects have been covered with 20 mL Hyalobarrier Gel in 10 randomly selected pigs. 2 weeks postoperatively the pigs got reoperated for evaluation of potential adhesions.


RESULTS
17 pigs remained for evaluation. 2 pigs died during introduction of anesthesia, one at the end of the operation. None of the pigs died due to a reaction to the gel. We found adhesions in 33% of the gel group (n=3 out of 9) and in 87.5% in the group without gel (7 out of 8): p < 0.05. Most of the adhesions have been found at the parietal defect (7 out of 17 at all).


CONCLUSIONS
The hyaluronic acid gel was highly efficacious and reduced the number and extent of adhesions throughout the abdomen following laparoscopic peritoneal surgery significantly.
Shamiyeh
A
A
Ludwig Boltzmann Institute for Operative Laparoscopy and 2nd Surgical Department Academic Teaching Hospital Linz, Austria. andreas.shamiyeh@aon.at
Danis
J
J
Benkö
L
L
Vattay
P
P
Röth
E
E
Tulipan
L
L
Shebl
O
O
Wayand
W
W
D000818:Animals; D005260:Female; D005782:Gels; D006820:Hyaluronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use*; D010532:Peritoneal Diseases / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D034421:Sus scrofa; D000267:Tissue Adhesions / Q000517:prevention & control
D005782:Gels; D006820:Hyaluronic Acid