Adhesions and adhesiolysis: the role of laparoscopy.
BACKGROUND
Adhesions commonly result from abdominal and pelvic surgical procedures and may result in intestinal obstruction, infertility, chronic pain, or complicate subsequent operations. Laparoscopy produces less peritoneal trauma than does conventional laparotomy and may result in decreased adhesion formation. We present a review of the available data on laparoscopy and adhesion formation, as well as laparoscopic adhesiolysis. We also review current adjuvant techniques that may be used by practicing laparoscopists to prevent adhesion formation.


METHODS
A Medline search using "adhesions," "adhesiolysis," and "laparoscopy" as key words was performed for English-language articles. Further references were obtained through cross-referencing the bibliography cited in each work.


CONCLUSIONS
The majority of studies indicate that laparoscopy may reduce postoperative adhesion formation relative to laparotomy. However, laparoscopy by itself does not appear to eliminate adhesions completely. A variety of adjuvant materials are available to surgeons, and the most recent investigation has demonstrated significant potential for intraperitoneal barriers. Newer technologies continue to evolve and should result in clinically relevant reductions in adhesion formation.
Kavic
Stephen M
SM
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06512, USA. stephen.kavic@yale.edu
Kavic
Suzanne M
SM
D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D000267:Tissue Adhesions / Q000150:complications / Q000209:etiology* / Q000517:prevention & control*