Effect of cross linked sodium hyaluronate in adhesion reduction within the gynecologic surgical window

摘要

Objectives: On an International scale the Surgical and Clinical Adhesion Research studies (SCAR) solidified the huge impact adhesions have on our Health Care System and the daily complications occurring at surgical procedures because of adhesions. Study: Retrospective file and chart review of 462 patients undergoing laparoscopic surgery at the Department of Obstetrics and Gynecology, University Hospitals of Schleswig Holstein, Kiel. Scientific background of HyaCorp endogel for adhesion prevention and reduction. Observational study applying HyaCorp endogel in 125 gynecological laparoscopic surgeries for adhesion reduction: Laparoscopic Total and subtotal hysterectomies(LTH, LSH) myomectomies and endometriosis surgeries. Additionally the application in 30 hysteroscopic surgeries such as polypectomies, intracavitary myomectomies and septum resections are described. Results: 50% of patients (P chronic pelvic pain had thick fibrous adhesions. HyaCorp endogel perfectly adheres to the tissue surface and the abdominal wall creating an anti adhesion barrier without any side effects. At hysteroscopies the application of 1 - 2 ml into the uterine cavity after intra-cavitary procedures was easily performed through a 2 mm cannula applicator. Postoperatively only in 2 cases patients had a slight pain over the first week, which did not continue. The gel was perfectly tolerated and showed no side effects. Conclusions and Discussion: Fibrous adhesions between pelvic organs and the pelvic side wall during gynecological surgical procedures with laparoscopy cause severe pain and further burden the task of the laparoscopic surgeon. The attempt to reduce these adhesions by applying the site specific, hyaloronic acid based barrier, HyaCorp endogel’ proved to be satisfying and helpful in this purely observational study.