This video demonstrates Davinci Robotic Adhesiolysis Surgery with Application of Interceed performed by Dr R K Mishra at World Laparoscopy Hospital. Interceed(TC7) is a fabric mechanical adhesive barriar composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. Use of Interceed is evaluated Interceed(TC7) in a randomized, multicenter clinical study and proved to be effective. Peritoneal adhesions following pelvic and abdominal surgery are a frequent cause of intestinal obstruction, reduced fertility, and pelvic pain. In gynecology, adhesion formation at the vaginal cuff and pelvic sidewall frequently involves bowel, omentum, and adnexa. Davinci robotic surgery is very effective method of doing adhesiolysis.
Postoperative adhesions are a common and challenging complication following abdominal and pelvic surgeries. They can lead to chronic pelvic pain, bowel obstruction, infertility, and difficulty during repeat surgeries. With advancements in minimally invasive surgery, Da Vinci robotic adhesiolysis combined with the application of Interceed (oxidized regenerated cellulose) has emerged as a safe, precise, and effective strategy to manage adhesions while minimizing their recurrence.

Understanding Adhesiolysis

Adhesiolysis is the surgical separation of abnormal fibrous bands (adhesions) that form between organs or tissues, often as a result of inflammation, infection, or previous surgery. Traditional open or conventional laparoscopic adhesiolysis can be technically demanding due to limited dexterity, two-dimensional vision, and the risk of inadvertent organ injury.

Role of the Da Vinci Robotic System

The Da Vinci robotic surgical platform offers significant advantages in complex adhesiolysis cases:

Three-dimensional high-definition visualization for precise identification of adhesion planes

Wristed robotic instruments with seven degrees of freedom, allowing meticulous dissection

Tremor filtration and enhanced ergonomics, reducing surgeon fatigue

Superior precision in dense, vascular, or bowel-related adhesions

These features make robotic adhesiolysis particularly valuable in patients with extensive pelvic or abdominal adhesions, including those following gynecologic, colorectal, or oncologic surgeries.

Surgical Technique: Robotic Adhesiolysis

After establishing pneumoperitoneum and docking the Da Vinci system, adhesiolysis is performed using sharp and blunt dissection. Energy devices are applied judiciously to minimize thermal injury. The robotic platform allows controlled traction and counter-traction, reducing the risk of bowel, bladder, or vascular damage. Meticulous hemostasis and gentle tissue handling are key principles throughout the procedure.

Application of Interceed

Interceed is an absorbable adhesion barrier composed of oxidized regenerated cellulose. It is widely used to reduce postoperative adhesion formation when placed correctly.

Key steps in Interceed application include:

Achieving complete hemostasis, as blood reduces its effectiveness

Cutting Interceed to appropriate size and shape

Gently placing it over raw or dissected peritoneal surfaces without suturing

Ensuring it remains dry and in direct contact with the target area

Interceed forms a temporary physical barrier between adjacent tissues during the critical healing phase and is absorbed within approximately two weeks.

Clinical Benefits

The combination of robotic precision and adhesion prevention with Interceed offers several advantages:

Reduced risk of adhesion recurrence

Lower incidence of postoperative pain and bowel obstruction

Improved fertility outcomes in selected gynecologic patients

Safer reoperative fields for future surgeries

Postoperative Outcomes

Patients undergoing Da Vinci robotic adhesiolysis generally experience:

Less postoperative pain

Shorter hospital stay

Faster recovery and return to daily activities

Lower complication rates compared to open surgery

Conclusion

Da Vinci robotic adhesiolysis with application of Interceed represents a modern, patient-centered approach to managing complex adhesions. By combining enhanced surgical precision with effective adhesion prevention, this technique improves short- and long-term outcomes while maintaining the benefits of minimally invasive surgery. As robotic platforms and biomaterials continue to evolve, this approach is likely to become a standard of care in complex adhesiolysis procedures.