Cross-linked sodium hyaluronate, an anti-adhesion barrier gel in gynaecological endoscopic surgery

Mettler, Liselotte; Sammur, Wael; Schollmeyer, Thoralf; Alkatout, İbrahim

doi:10.3109/13645706.2012.751034

Cited by 11 publications

(5 citation statements)

References 26 publications

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“…The ultrasonographic parameters (ovarian adhesion, mobility, fading margin, and SST) showed the superiority of the application of Endo gel on the ovaries compared to ovarian suspension within three months. These results are in agreement with previous studies, suggesting Endogel as an effective adhesion-preventing factor [ 11 , 12 ] in gynecologic laparoscopic and hysteroscopic surgery [ 18 ]. However, they have not addressed ovarian adhesions solely and have considered various gynecological procedures.…”

Section: Discussionsupporting

confidence: 93%

Hyaluronic acid gel application versus ovarian suspension for prevention of ovarian adhesions during laparoscopic surgery on endometrioma: a double-blind randomized clinical trial

et al. 2022

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Background This study aimed to compare the effect of ovarian suspension and hyaluronic acid gel to prevent re-adhesions after laparoscopic endometrioma surgery. Methods This randomized clinical trial was conducted at Rasoul-e-Akram and Pars Hospitals, Tehran, Iran, 2016-18. Fifty patients with bilateral endometrioma and pelvic adhesions, the candidates of laparoscopic surgery, were included. In each patient, at the end of ovarian cystectomy and adhesiolysis, one of the ovaries was randomly sutured to the abdominal wall, and the HYAcorp Endogel covered the other; the adhesion rate was compared between the groups by ultrasonography, three-month after surgery. Results Mean age of patients was 32.6 years. Presurgical variables were similar between right and left ovaries and the study groups (P > 0.05). Postsurgical ultrasonography showed that ovarian soft markers, including < 1/3 ovarian adhesions (minimal adhesions) in 80.5% of ovaries of the Endogel group and 35.5% of the ovarian suspension group (P < 0.001) with higher ovarian mobility in the Endogel group (65% vs. 22%) (P = 0.001). In addition, site-specific tenderness and ovarian fading margin were lower in the Endogel group (P < 0.001). Trial registration Clinical trial registry number: IRCT2015081723666N1, 12.19.2015, Date of registration: 01/02/2016; https://en.irct.ir/trial/20174?revision=20174. Date and number of IRB: 2015, I.R.IUMS.REC.1394.24703. Conclusion Hyaluronic acid gel can be more effective than ovarian suspension in preventing ovarian adhesions after laparoscopic treatment of endometriosis.

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Section: Discussionsupporting

confidence: 93%

Hyaluronic acid gel application versus ovarian suspension for prevention of ovarian adhesions during laparoscopic surgery on endometrioma: a double-blind randomized clinical trial

et al. 2022

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“…In a previous study of 25 second-look laparoscopies the incidence of adhesions was 8% and severity of the adhesions was 16% but there was no report of the extent of adhesions [14]. In the 10 second-look hysteroscopies no intrauterine adhesions were observed.…”

Section: Scientific Background For Hya Corp Endogel (Bio Science Germentioning

confidence: 83%

“…The next Generation site specific hyaluronic acid based adhesion barrier gel presented in this observational study with the Crosslinked HyaCorp endogel opens new challenges for adhesion prevention, although no randomized controlled studies are as yet available. The effectivity has been demonstrated in a few animal studies and in 35 second look laparoscopies and hysteroscopies in the field of gynecology [14].…”

Section: Hyaluronic Acidmentioning

confidence: 93%

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

Mettler¹

2014

OJOG

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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 < 0.005) with chronic pelvic pain had thick fibrous adhesions. Hya-Corp 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, Hya-Corp endogel' proved to be satisfying and helpful in this purely observational study.

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“…Awareness of potential complications, their early detection, and professional treatment are essential aspects of a high-quality operating unit. 3,20,21 …”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Complications of Laparoscopy in Connection with Entry Techniques

Alkatout

2017

Journal of Gynecologic Surgery

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The anatomy of the human being has not changed. However, technical developments in operating materials and methods call for improvements in surgical procedures as well as the management of complications. A fundamental distinction between any operating method and laparoscopy is that, in the latter, the initial entry is usually performed in blind fashion. Blind entry may result in vessel or organ damage, especially in patients who have undergone previous surgery. One of the difficulties associated with the entry is that the damage may not be identified immediately and then necessitate major abdominal repair. Furthermore, the improvement of surgical instruments and techniques enables the surgeon to perform even major operations by the laparoscopic approach. This is associated with renewed learning curves and a high rate of complications due to vascular, bowel, uterine, or bladder damage. The improvement of surgical techniques must be accompanied by advancements in the management of complications. The aim of this review is to address the risks of laparoscopy as well as their correct and professional management. (J GYNECOL SURG 33:81)

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Cross-linked sodium hyaluronate, an anti-adhesion barrier gel in gynaecological endoscopic surgery

Abstract: Cross-linked sodium hyaluronate is highly effective in the prevention of adhesions at laparoscopic and hysteroscopic surgery.

Cited by 11 publications

References 26 publications

Hyaluronic acid gel application versus ovarian suspension for prevention of ovarian adhesions during laparoscopic surgery on endometrioma: a double-blind randomized clinical trial

Hyaluronic acid gel application versus ovarian suspension for prevention of ovarian adhesions during laparoscopic surgery on endometrioma: a double-blind randomized clinical trial

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

Complications of Laparoscopy in Connection with Entry Techniques

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