Objective: To assess whether use of antiadhesive liquids or coatings could prevent adhesion formation to prosthetic mesh. Summary Background Data: Incisional hernia repair frequently involves the use of prosthetic mesh. However, concern exists about development of adhesions between viscera and the mesh, predisposing to intestinal obstruction or enterocutaneous fistulas. Methods: In 91 rats, a defect in the muscular abdominal wall was created, and mesh was fixed intraperitoneally to cover the defect. Rats were divided in five groups: polypropylene mesh only (control group), addition of Sepracoat or Icodextrin solution to polypropylene mesh, Sepramesh (polypropylene mesh with Seprafilm coating), and Parietex composite mesh (polyester mesh with collagen coating). Seven and 30 days postoperatively, adhesions were assessed and wound healing was studied by microscopy. Results: Intraperitoneal placement of polypropylene mesh was followed by bowel adhesions to the mesh in 50% of the cases. A mean of 74% of the mesh surface was covered by adhesions after 7 days, and 48% after 30 days. Administration of Sepracoat or Icodextrin solution had no influence on adhesion formation. Coated meshes (Sepramesh and Parietex composite mesh) had no bowel adhesions. Sepramesh was associated with a significant reduction of the mesh surface covered by adhesions after 7 and 30 days. Infection was more prevalent with Parietex composite mesh, with concurrent increased mesh surface covered by adhesions after 30 days (78%). Conclusions: Sepramesh significantly reduced mesh surface covered by adhesions and prevented bowel adhesion to the mesh. Parietex composite mesh prevented bowel adhesions as well but increased infection rates in the current model. Incisional hernias occur in 5% to 20% of patients after abdominal surgery. 1–4 In incisional hernia repair, the introduction of tension-free techniques by using prosthetic material has reduced recurrence rates from up to 50% to less than 24%. 5–9 However, foreign materials, such as prosthetic mesh, represent a strong stimulus for the development of permanent adhesions. 10 Particularly if the mesh is placed intraperitoneally, concern exists about development of adhesions between bowel and mesh. These adhesions can cause serious complications, such as intestinal obstruction and enterocutaneous fistulas. 11–14 The aim of the present study was to assess whether adhesions due to intraperitoneal mesh can be prevented by the use of physical barriers that can be applied laparoscopically. For this purpose, we assessed if intraperitoneal administration of liquid physical barriers composed of hyaluronic acid (Sepracoat, HAL-C; Genzyme Corp., Cambridge, MA) or Icodextrin solution (Extraneal, Baxter Healthcare Inc.) could prevent adhesions to a polypropylene mesh without interfering with wound healing and tissue incorporation of the mesh. In addition, we studied the ability of specifically coated meshes, Sepramesh (Genzyme) and Parietex composite mesh (Sofradim, France), to prevent adhesions.