Clinical Evaluation for Reduction of Adhesions by a Viscoelastic Gel in Gynecological Laparoscopic Surgery
Cyriac Pappachan
Citation Information :
Pappachan C. Clinical Evaluation for Reduction of Adhesions by a Viscoelastic Gel in Gynecological Laparoscopic Surgery. World J Lap Surg 2009; 2 (1):7-12.
In third party-blinded, randomized, four center studies, patients from 18-46 years underwent surgical laparoscopy in which adnexa and adjacent tissues were coated with viscoelastic gel. They underwent for a second look 6-10 weeks later. Adhesion scores of American fertility society were quantified with the blinded reviews of videotapes
Result
For 25 patients, surgery was done on 45 adnexa. Surgical sites with risk of adhesion was covered with approximately 15 ml of viscoelastic gel in approximately 90 seconds. For 24 control patients, surgery alone was done on 41 adnexa. Decrease in AFS score (11.9-9.1) was seen in treated adnexa. In control adnexa increase in AFS score (8.8-15.8) seen. The difference (42% reduction) seen in second look AFS score is significant (p < 0.01).
Conclusion
Laparoscopic administration of viscoelastic gel was easy and had significant reduction in adnexal adhesions. The patients undergoing gynecological surgeries were benefited.
Adhesion prevention in the surgical treatment of pelvic endometriosis. Gynecol Endosc 2001;10:99-106.
The impact of adhesions on hospital readmissions over ten years after 8849 open gynaecological operations: An assessment from the Surgical and Clinical Adhesions Research Study. Br J Obstet Gynecol 2000;107:855-62.
Central Surgical Assoc, 60th Annual Meeting. Surgery 2003;549-54.
In diZerega GS (Ed). Peritoneal Surgery. Springer-Verlag, New York 2000;329-33.
Reduction of postsurgical adhesions with ferric hyaluronate gel: A European Study. Hum Reprod 2001;16,1982-88.
A randomised, controlled pilot study of the safety and efficacy of 4% icodextrin solution (Adepte) in the reduction of adhesions following laparoscopic gynaecological surgery. Hum Reprod 2002;17:1031-38.
Reduction of postoperative adhesions by N,Ocarboxymethylchitosan: A pilot study. Fertil Steril 80:631-36.
Reduction of radiculopathy and pain with Oxiples/SP Gel after laminectomy, laminotomy, and discectomy. Spine 2003;28:1080-87.
Postsurgical adhesion reformation is inhibited by Oxiplex adhesion barrier gel. In Marana R, Busacca M, and Zupi E (Eds). International Proceedings. World Meeting on Minimally Invasive Surgery in Gynecology, Rome 2003;17-21.
Quantitation of peritoneal adhesions and correlation with clinical outcomes. Infertil Repord Med Clin N Am 2003;14:431-56.
In diZerega GS (Ed). Peritoneal Surgery. Springer-Verlag, New York, 2000;217-20.
Adhesion barriers of carboxymethyl cellulose and polyethylene oxide composite gels. J Biomed Met Res 2002;63:326-32.
Reduction of epidural fibrosis in lumbar surgery with Oxiplex adhesion barriers of carboxymethylcellulose and polyethylene oxide. Spine J 2003;3:277-84.
Reduction of radiculopathy and pain with Oxiples/SP Gel after laminectomy, laminotomy and discectomy. Spine 2003;28;1080-87.
Postsurgical adhesion reformation is inhibited by Oxiplex adhesion barrier gel. InMarana R, Busacca M, and Zupi E (Eds). International Proceedings. World Meeting on Minimally Invasive Surgery in Gynecology, Rome 2003;17-21.
Quantitation of peritoneal adhesions and correlation with clinical outcomes. Infertil Reprod Med Clin N Am 2003;14:431-56.
Classification of adhesion. In diZerega GS (ed.) Peritoneal Surgery. Springer-Verlag, New York 2000;221-28.
