Table 2 Overview of the available anti-adhesion agents
Agent | Approval | Safety | Limitations | Clinical studies | Cost | |
|---|---|---|---|---|---|---|
Europe* | US FDA | |||||
Site-specific | ||||||
Preclude | ✓ | ✓ Tissue separation | ✓ | Suture in place | Limited | €€ |
Interceed | ✓ | ✓ Open | ✓ | Incompatible with blood | Many studies | €€ |
Remove irrigants before use | - One limited pregnancy outcomes | |||||
Handling | study | |||||
Seprafilm | ✓ | ✓ Open | ✓ But anastomosis | Remove irrigants before use | A number of studies | €€(€) |
Handling | - Laparotomy only | |||||
Difficult to apply in laparoscopy | - SBO study - limited results | |||||
SprayGel | ✓ | No | ? | Complex and capital equipment needed | Very limited | €€€ |
- Pivotal study halted | ||||||
Hyalobarrier gel | ✓ | No | ✓ | Handling | Limited | €(€) |
No irrigation after application | - One limited pregnancy outcomes study | |||||
SurgiWrap | ✓ | No | ? | Peritoneal replacement film | None | €€(€) |
No clinical data on adhesion reduction | ||||||
Suture in place | ||||||
Oxiplex AP gel | ✓ | No | ✓ | Availability | Very limited | ?? |
- Pilot studies only | ||||||
Broad coverage | ||||||
Adept | ✓ | ✓ Lap | ✓ | Clinical studies in laparoscopy only | Limited | € |
- Double blind study | ||||||
- Active control | ||||||