Surgical adhesions: A timely update, a great challenge for the future

Davey, Andrew K.; Maher, Peter

doi:10.1016/j.jmig.2006.07.013

Cited by 115 publications

(110 citation statements)

References 68 publications

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“…This causes activation of the extrinsic pathway of the coagulation cascade and the formation of an exudate rich in fibrin [19]. Adhesions can lead to infertility, dyspareunia, chronic pelvic pain, and complications at repeated surgery [20,21]. Adhesions may produce disruption of the normal anatomy, thus altering normal tubal performance.…”

Section: Discussionmentioning

confidence: 99%

“…Adhesions may produce disruption of the normal anatomy, thus altering normal tubal performance. Thus, follicular growth, pick-up of the oocyte after ovulation and spermatozoa or embryo transport may be impaired [20]. Several women develop postoperative adhesions after laparoscopy surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The most common site of postoperative adhesions formation is the ovary [12,22]. Although several surgical measures and systemic pharmacologic treatments for adhesions prevention have been proposed, the rate of periovarian adhesion formation was not significantly reduced [13,[20][21][22]. The high incidence of postoperative adhesions in endometriosis patients and their clinical significance underline the importance of modifying surgical technique in order to reduce potential adhesion formation.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of ovarian suspension to round ligament with a resorbable suture to prevent postoperative adhesions in women with ovarian endometrioma: follow-up by transvaginal hydrolaparoscopy

et al. 2014

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The aim of this study was to assess the effect of ovarian suspension to the round ipsilateral ligament with a resorbable suture, performed during laparoscopic surgery for endometrioma, on postoperative ovarian adhesion formation. The tool used to assess this effect was not conventional laparoscopy but outpatient transvaginal hydrolaparoscopy. Fifty women with single ovarian endometrioma were divided in two groups (group A, 24 and group B, 26). All patients underwent laparoscopic ovarian cystectomy for endometriosis. In group A, the ovary was suspended to the ipsilateral round ligament. In group B, ovarian suspension was not performed. All patients underwent transvaginal outpatient hydrolaparoscopy as follow-up. A significantly lower rate of postsurgical ovarian adhesion in group A in comparison with group B (33.3 vs 80.8 %-p=0.001) was observed. Operative time and postoperative pain were similar in both groups. Ovarian suspension to the ipsilateral round ligament with a resorbable suture during surgery for endometrioma is associated with a lower rate of postoperative ovarian adhesion formation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy of ovarian suspension to round ligament with a resorbable suture to prevent postoperative adhesions in women with ovarian endometrioma: follow-up by transvaginal hydrolaparoscopy

et al. 2014

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“…Careful tissue handling, keeping tissue moist, meticulous homeostasis, minimization of tissue ishcaemia and excessive tissue desiccation, the use of micro and a-traumatic instruments reduces serosal injury and these all have very importantrollto prevent the adhesive disorders 8 .…”

Section: Surgical Principles To Prevent Adhesionsmentioning

confidence: 99%

Prevention of Postoperative Adhesions of Caesarean Section

Nasreen

Shahreen

Huq

et al. 2017

J. Bangladesh Coll. Phys.

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Adhesions means fibrous or scar tissue that results from the healing process. Up to 95% of patients who have surgery develop adhesions. Adhesions formation and its long term sequel is a well known complication of the surgery but unfortunately very little is investigated about the prevention. The long term morbidities such as chronic pelvic pain, secondary infertility, hospital readmission, bowel obstruction, difficult repeat C/S with increased bleeding, longer operative time, injury to bowel ,bladder, ureters and placental accreta spectrum disorder from adhesions are the main concern. The cost for these adhesions is extreme burden for the developing countries.

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“…Adhesions of the abdomen or pelvis may cause intestinal obstruction, chronic pain, difficult subsequent surgery, and infertility [1]. Adhesions may adversely affect fertility by distortion of tubal anatomy and thereby interference with gamete and embryo transport and by alteration of the fimbrio-ovarian relation so as to prevent retrieval of the cumulus oophorus.…”

Section: Introductionmentioning

confidence: 99%

A New Technique of Laparoscopic Ovarian Suspension with Microsuture for Adhesion Prevention in Patients Undergoing Fertility Enhancing Surgery

Taylor¹,

McComb²

2008

TORSJ

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Abstract:A new laparoscopic technique of ovarian suspension with microsuture that physically separates the ovary from the ovarian fossa to reduce the incidence of post-operative adhesions is described. Four women with adhesions of the ovary to the ovarian fossa and infertility underwent laparoscopic surgery with ovarian suspension. A 6-0 weight polypropylene swaged to a tapered straight needle was passed laterally to medially through the ipsilateral round ligament, through the mesosalpinx and then through the medial aspect of the ovarian insertion of the utero-ovarian ligament. The needle was then passed back through the mesosalpinx and round ligament and tied. The technique, technical feasibility, ease of procedure and post-operative complication rate is detailed. This technique separates the ovarian surface from the peritoneum of the ovarian fossa yet maintains the normal adnexal anatomy.

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Surgical adhesions: A timely update, a great challenge for the future

Cited by 115 publications

References 68 publications

Efficacy of ovarian suspension to round ligament with a resorbable suture to prevent postoperative adhesions in women with ovarian endometrioma: follow-up by transvaginal hydrolaparoscopy

Efficacy of ovarian suspension to round ligament with a resorbable suture to prevent postoperative adhesions in women with ovarian endometrioma: follow-up by transvaginal hydrolaparoscopy

Prevention of Postoperative Adhesions of Caesarean Section

A New Technique of Laparoscopic Ovarian Suspension with Microsuture for Adhesion Prevention in Patients Undergoing Fertility Enhancing Surgery

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