A novel hyaluronan-based gel in laparoscopic adhesion prevention: preclinical evaluation in an animal model

Abstract

Objective: To evaluate the effectiveness of a crosslinked hyaluronan solution (ACP gel) in the prevention of postsurgical adhesions in laparoscopic surgery.

Design: A randomized blinded study using a rabbit model in laparoscopic surgery.

Setting: A standardized surgical trauma in the rabbit uterine horn to induce adhesion formation.

Animals: Sixty-four sexually matured female New Zealand white rabbits weighing 2.5 to 3.0 kg and aged 3-4 months.

Intervention(s): After trauma, group 1 (n = 22) received no treatment, group 2 animals (n = 20) received oxidized-regenerated cellulose (Interceed [TC7]) in group 3 (n = 22) 5 mL of ACP gel were applied on the lesion.

Main outcome measure(s): Six weeks after laparoscopy, a laparotomy was performed and the adhesions were scored according to Blauer's scoring system.

Result(s): 66% of the untreated animals and 85% of the animals treated with Interceed presented with severe adhesions, whereas only 35% of the ACP gel treatment group had significant adhesions. The mean ( +/- SEM) increased adhesion score was 2.24 +/- 0.26 in the untreated group, 2.45 +/- 0.22 in the Interceed group, and was 1.25 +/- 0.28 in the ACP gel group.

Conclusion(s): This study revealed that ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparoscopic surgery.