Efficiency of TachoSil® to prevent postsurgical adhesion development on laparoscopic rat model

Abstract

The aim of this study was to evaluate the effectiveness of a fibrinogen and thrombin-coated hemostatic sponge (TachoSil®) in the prevention of postsurgical adhesions in a laparoscopic rat model and its histological effects on uterine and peritoneal parenchyma. Design was a prospective randomized blinded study. Setting was in International Laparoscopic Surgery Centre, Clermont-Ferrand, France. There were 100 sexually mature female Sprague-Dawley rats weighing 240 to 300 g and aged 6-8 weeks. A standardized severe surgical injury induced by scissors and 40-W bipolar coagulation in the rat uterine horn, corpus, and peritoneum was performed to induce adhesion formation. After trauma, group 1 (n=50) received no treatment and group 2 rats (n=50) received TachoSil® applied on injured areas. Twelve weeks after the procedure, repeat laparoscopy was performed and adhesions were scored according to their extent and severity. A hysterectomy and a peritoneal biopsy in the injured area were achieved by laparotomy in order to investigate on a possible earlier effect of TachoSil® on the uterine and peritoneal parenchyma in 49 rats of each group. TachoSil® group adhesion scores showed a significant decrease on the three injured areas: peritoneum (12.96 vs. 21.66), uterine horn (7.22 vs. 15.20), and uterine corpus (5.88 vs. 34.52). TachoSil® group also demonstrated a major decline of uterine fibrosis and inflammation. This study revealed that TachoSil®, an absorbable biomaterial, can reduce postoperative adhesions after laparoscopic surgery on a rat model. TachoSil® also prevents thermo-induced injuries on uterine parenchyma (less fibrosis and less inflammation). © 2009 Springer-Verlag.