Post-surgical adhesion prevention with a biodegradable gel compatible with laparoscopic use

Abstract

A useful laparoscopic product for adhesion prevention must be easy to apply with minimal handling and manipulation of tissue and product. With this objective in mind, we have developed an injectable gel (HALTM) based on hyaluronic acid that is intended to limit adhesion formation after laparoscopic and open surgical procedures. We tested the effectiveness of HALTM gels in a rat sidewall defect model. In 50 adult female rats a 1 cm x 1 cm peritoneal defect was made along the abdominal wall. The defect was enclosed with #3-0 silk suture to induce ischemia. The animals were randomized to gel treatment (0.5 ml placed on defect) or non-treatment control groups. Seven days after surgery the extent (0-4 scale) and severity (0-3 scale) of adhesions were scored. HALTM gel significantly reduced the extent and severity of sidewall adhesions. Moreover, the number of animals with no adhesions was significantly increased compared with non-treatment. These results indicate that HALTM gel, which is easily applied to tissue and organs, may be a useful adjuvant for adhesion prevention in open and laparoscopic surgical procedures. The effectiveness and safety of HALTM gels will be tested in human clinical studies.