Prevention of adhesions during robot-assisted bowel resection for endometriosis

А.А. Popov, A.A. Fedorov, Yu.D. Davydova, T.A. Glebov
In: Medical Robotics · 2026 · vol. 1(1) , pp. 61–65 · doi:10.63769/3033-6392-2026-1-1-61-65 · W7155070434
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This prospective trial evaluated a hyaluronic acid-containing anti-adhesion gel in robot-assisted bowel resection for endometriosis, finding it safe with no increased postoperative complications.

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The paper studied whether a sodium hyaluronate-based anti-adhesion gel (AntiAdgezin) is safe when used around the site of intestinal anastomosis during robot-assisted surgery for deep infiltrating endometriosis involving the bowel. In a single-center prospective controlled trial with parallel groups (76 women randomized to gel vs no barrier), postoperative safety was assessed by rates of complications including anastomotic leak, peritonitis, abdominal abscesses, and sepsis, alongside close monitoring of inflammatory laboratory markers. The authors found that using the hyaluronate barrier was not associated with increased postoperative complication rates, including anastomotic failure (all comparisons p > 0.05). This paper is centrally about endometriosis — it evaluates the safety of an anti-adhesion hyaluronate gel during robot-assisted bowel resection for deep infiltrating endometriosis.

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Abstract

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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Профилактика образования спаек при робот-ассистированной резекции кишечника по поводу эндометриоза https://doi.org/10.63769/3033-6392-2026-1-1-61-65 Аннотация 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. 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. Использование противоспаечного барьера на основе гиалуроната натрия не ассоциировалось с увеличением частоты послеоперационных осложнений, включая несостоятельность анастомоза (p >0,05 для всех сравнений). 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. Ключевые слова Об авторах А. А. ПоповРоссия 101000 Москва, ул. Покровка, 22а А. А. 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Beck D.E., Cohen Z., Fleshman J.W. et al.; Adhesion Study Group Steering Committee. A prospective, randomized, multicenter, controlled study of the safety of Seprafilm adhesion barrier in abdominopelvic surgery of the intestine. Dis Colon Rectum 2003;46(10):1310–9. DOI: 10.1007/s1035000467392 32. Warschkow R., Tarantino I., Ukegjini K. et al. Diagnostic study and metaanalysis of Creactive protein as a predictor of postoperative inflammatory complications after gastroesophageal cancer surgery. Langenbecks Arch Surg 2012;397(5):727–36. DOI: 10.1007/s0042301209446 Рецензия Для цитирования: Попов А.А., Федоров А.А., Давыдова Ю.Д., Глебов Т.А. Профилактика образования спаек при робот-ассистированной резекции кишечника по поводу эндометриоза. Медицинская робототехника. 2026;1(1):61-65. https://doi.org/10.63769/3033-6392-2026-1-1-61-65 For citation: Popov A.A., Fedorov A.A., Davydova Yu.D., Glebov T.A. Prevention of adhesions during robot-assisted bowel resection for endometriosis. Medical Robotics. 2026;1(1):61-65. (In Russ.) https://doi.org/10.63769/3033-6392-2026-1-1-61-65 JATS XML

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