Adhesion formation after transperitoneal nephrectomy: laparoscopic v open approach.
The risk of postoperative adhesion formation is a significant concern with transperitoneal laparoscopic surgery. To evaluate the incidence of adhesions after major interventional urologic laparoscopy, 16 pigs underwent either laparoscopic (N = 8) or transperitoneal open (N = 8) nephrectomy. Adhesions occurred at 12.5% of the operative sites in the laparoscopic group compared with 75% of the operative sites of the open group. Adhesions were present along the incision site in all the pigs in the open group compared with 5 of 40 (12.5%) trocar sites in the laparoscopic group. Adhesion number, grade, and extent were significantly greater in the open group than the laparoscopic group for both nephrectomy and access (incision/trocar) sites (p < 0.05). Transperitoneal laparoscopic urologic surgery in the porcine model results in a marked decrease in adhesion formation compared with incisional transabdominal surgery.
Moore
R G
RG
Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA.
Partin
A W
AW
Adams
J B
JB
Kavoussi
L R
LR
D000009:Abdominal Muscles; D000818:Animals; D005069:Evaluation Studies as Topic; D010535:Laparoscopy; D009135:Muscular Diseases / Q000209:etiology; D009392:Nephrectomy / Q000379:methods*; D010532:Peritoneal Diseases / Q000209:etiology*; D011183:Postoperative Complications; D013552:Swine; D000267:Tissue Adhesions / Q000209:etiology*