medrobМедицинская робототехникаMedical Robotics3033-63923033-8115MedINK10.63769/3033-6392-2026-1-1-61-65medrob-43Research ArticleРЕПРОДУКТИВНАЯ ХИРУРГИЯREPRODUCTIVE SURGERYПрофилактика образования спаек при робот-ассистированной резекции кишечника по поводу эндометриозаPrevention of adhesions during robot-assisted bowel resection for endometriosishttps://orcid.org/0000-0001-8734-1673ПоповА. А.PopovA. A.

101000 Москва, ул. Покровка, 22а 

22a Pokrovka St., Moscow 101000 

https://orcid.org/0000-0003-2590-5087ФедоровА. А.FedorovA. A.

Антон Андреевич Федоров 

101000 Москва, ул. Покровка, 22а 

Anton Andreevich Fedorov 

22a Pokrovka St., Moscow 101000 

aa.fedorov@mail.ruhttps://orcid.org/0009-0007-3916-4677ДавыдоваЮ. Д.DavydovaYu. D.

101000 Москва, ул. Покровка, 22а 

22a Pokrovka St., Moscow 101000 

https://orcid.org/0000-0001-6816-5360ГлебовТ. А.GlebovT. A.

101000 Москва, ул. Покровка, 22а 

22a Pokrovka St., Moscow 101000 

ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии им. акад. В.И. Краснопольского»РоссияV.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and GynecologyRussian Federation202619042026116165Copyright © Попов А.А., Федоров А.А., Давыдова Ю.Д., Глебов Т.А., 20262026Попов А.А., Федоров А.А., Давыдова Ю.Д., Глебов Т.А.Popov A.A., Fedorov A.A., Davydova Y.D., Glebov T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medrobot-j.com/jour/article/view/43Введение

Введение. Безопасность применения противоспаечных средств при наложении кишечного анастомоза при любом типе хирургического доступа остается предметом дискуссии.

Цель исследования – оценка безопасности использования противоспаечного геля на основе гиалуроната натрия при наложении кишечного анастомоза в ходе робот-ассистированного вмешательства по поводу глубокого инфильтративного эндометриоза.

Материалы и методы

Материалы и методы. Проведено одноцентровое проспективное контролируемое исследование с параллельными группами. В исследование включено 76 пациенток с глубоким инфильтративным эндометриозом и поражением кишечника, которые были распределены по 2 группам: основной и контрольной. В основной группе в ходе операции применяли гелевый противоспаечный барьер на основе гиалуроната натрия («Антиадгезин»), в контрольной группе барьер не применяли. Оценивали безопасность противоспаечного средства на основании анализа частоты послеоперационных осложнений (несостоятельности анастомоза, перитонита, абсцессов брюшной полости, сепсиса), а также тщательного мониторинга лабораторных маркеров воспаления в послеоперационном периоде.

Результаты

Результаты. Использование противоспаечного барьера на основе гиалуроната натрия не ассоциировалось с увеличением частоты послеоперационных осложнений, включая несостоятельность анастомоза (p >0,05 для всех сравнений).

Заключение

Заключение. Продемонстрирована высокая безопасность противоспаечного барьера на основе гиалуроната натрия при использовании в зоне кишечного анастомоза. Полученные результаты свидетельствуют о целесообразности проведения дальнейших масштабных исследований для подтверждения эффективности и безопасности применения барьера в ходе различных лапароскопических вмешательств.

Introduction

Introduction. The use of anti-adhesion barriers in intestinal anastomoses, regardless of surgical approach, remains controversial in terms of their safety.

Aim

Aim. To evaluate the safety of a hyaluronic acid-containing anti-adhesion gel in intestinal anastomosis during robot-assisted procedures for deep infiltrating endometriosis.

Materials and methods

Materials and methods. A single-center, prospective, controlled trial was conducted in 76 patients with deep infiltrating endometriosis and bowel lesions. Randomization to the control and study intervention groups was based on the use of a hyaluronic acid-containing gel anti-adhesion barrier (Antiadhesin). The evaluation protocol included careful monitoring of clinical parameters (the incidence of postoperative complications: anastomotic leakage, peritonitis, abdominal abscesses, sepsis), as well as laboratory markers of inflammation in the postoperative period.

Results

Results. The use of a hyaluronic acid-containing anti-adhesion barrier was not associated with an increased incidence of postoperative complications, including anastomotic leakage (p > 0.05 for all comparisons).

Conclusion

Conclusion. An anti-adhesion barrier composed of carboxymethylcellulose and hyaluronic acid demonstrates a favorable safety profile when used in intestinal anastomoses. The obtained results support the need for further large-scale studies to confirm the efficacy and safety of this barrier in various types of laparoscopic procedures.

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The authors declare that there are no conflicts of interest present.