New adhesion formation after laparoscopic and conventional adhesiolysis

Abstract

This study aimed to compare new adhesion formation after laparoscopic and conventional adhesiolysis. In a first operation, 24 rabbits underwent fixation of deserosated cecum (6 cm2) to the lateral abdominal wall to induce standardized adhesions. After 4 weeks, adhesiolysis was performed by laparoscopy (n = 12) or laparotomy (n = 12). Outcome was assessed by the incidence, extent, and location of adhesion reformation. After conventional adhesiolysis, new adhesions developed in all the rabbits, as compared with 75% after laparoscopic adhesiolysis. The extent of newly formed adhesions was significantly reduced (p < 0.001) after laparoscopic adhesiolysis (368+/-115 mm2) as compared with conventional adhesiolysis (2434+/-245 mm2). There were no adhesions to trocar wounds, but adhesions to the abdominal incision were found in 33% of the conventional group. In a rabbit model comparing laparoscopic and conventional adhesiolysis in a standardized experimental setting, laparoscopic adhesiolysis is associated with a significantly reduced formation of new postoperative adhesions.

Long-term outcome, adhesions, and quality of life after laparoscopic and open surgical therapies for acute abdomen: follow-up of a prospective trial

“…Generally in the present study, a higher readmission rate for ileus was observed in the O group than the L group. However, recent experimental and clinical reports have suggested that the risk of adhesion ileus associated with previous operation can be lowered by laparoscopic access [19,45,46]. One study reported at relaparoscopy a 10% risk of adhesion formation after previous laparoscopic operation vs an 80% risk after previous open operation [11].…”

Evaluation of agar films in prevention of postoperative peritoneal adhesions in animal model

“…However, none of the barriers has yet achieved sustained success. [5,6] Current agents such as HA-CMC (sodium hyaluronate -carboxymethylcellulose) and icodextrin are widely used in clinical practice, but the results with respect to their antiadhesive efficacy and biocompatibility are conflicting.…”

“…However, the success of the current methods in adhesion prevention has not been satisfactory. [14,15] The biocompatibility of the currently used antiadhesive products is not reliable. Several cases of postoperative acute aseptic peritonitis have been reported after using HA-CMC (Seprafilm) or 4% icodextrin (Adept).…”

Abdominal adhesions: intestinal obstruction, pain, and infertility

“…Hence, laparoscopy is likely to induce fewer adhesions than conventional laparotomy [21,22,27]. In experimental studies, laparoscopy caused fewer adhesions than laparotomy [19,23,31,49,75,87]. Lundorff et al also observed fewer adhesions after laparoscopic tubal surgery than after open surgery [51].…”