Prevention of adhesions during robot-assisted bowel resection for endometriosis

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

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. 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. 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. 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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