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 [TC71), 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.