Prevention of de novo adhesion by ferric hyaluronate gel after laparoscopic surgery in an animal model

Abstract

Background and objective: Adhesions remain a major cause of severe long-term complications. Attempts have been made to prevent adhesion formation by using endogenous or exogenous materials with controversial results. Our aim was to evaluate the efficacy of 0.5% ferric hyaluronate gel in the prevention of adhesion formation after laparoscopic surgery.

Methods: This was a prospective, randomized, experimental study (animal model). The study population comprised 75 female rabbits (Fauve de Bourgogne) weighing over 3 kg. The rabbits were randomized into 3 groups of 25 (hyaluronate, saline, and control) by using a predetermined computer-generated randomization code. All rabbits underwent a peritoneal laparoscopic resection, and the main outcome measure was the adhesion formation after laparoscopic surgery.

Results: The laparoscopic operating time and the mean interval before second-look surgery were not different among the 3 groups. The number of rabbits with adhesions did not differ among the 3 groups. The bowel adhesion rate was higher at the 10-mm trocar site than at the 5-mm trocar site (P=0.01). The adhesion scores did not differ among the 3 groups. A strong correlation was found between the values of the different adhesion scoring systems used.

Conclusion: These results obtained in a rabbit model suggest that routine intraperitoneal application of hyaluronate gel does not prevent adhesion formation after laparoscopic surgery.