title: Adhesion formation after laparoscopic excision of endometriosis and lysis of adhesions.
abstract: OBJECTIVE
  To evaluate adhesion reformation after laparoscopic excision of endometriosis and adhesiolysis in women with chronic pelvic pain.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Thirty-eight women with endometriosis and chronic pelvic pain.
  
  
  METHODS
  A primary and second-look laparoscopy with adhesiolysis and excision of endometriotic lesions with a neodymium-yttrium argon garnet surgical laser technologies (SLT) contact laser.
  
  
  METHODS
  Adhesion formation and character (thin, thin and thick, or thick). Location of adhesions at a first laparoscopy was compared with de novo or reformation of adhesions and the location of adhesions at a second surgery.
  
  
  RESULTS
  Adhesions or adhesions combined with endometriotic lesions were significantly more likely to reform at second surgery compared with sites having only an endometriosis lesion. Thick adhesions were associated with a significantly increased likelihood of an adhesion reforming, compared with thin adhesions or thin and thick adhesions. Lesions or adhesions involving the ovary were more likely to be associated with adhesions at a subsequent surgery, compared with lesions in the adjacent ovarian fossa or fallopian tube.
  
  
  CONCLUSIONS
  Most patients developed adhesions after radical surgical excision of endometriosis for pelvic pain. The high incidence of adhesion formation after surgery for endometriosis underscores the importance of optimizing surgical techniques to potentially reduce adhesion formation.
authors.affiliation: National Institutes of Health, Bethesda, MD, USA.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Parker
authors.forename: Ninet
authors.initials: N
authors.lastname: Sinaii
authors.forename: James H
authors.initials: JH
authors.lastname: Segars
authors.forename: Heidi
authors.initials: H
authors.lastname: Godoy
authors.forename: Craig
authors.initials: C
authors.lastname: Winkel
authors.forename: Pamela
authors.initials: P
authors.lastname: Stratton
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D017699:Pelvic Pain / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000601:surgery*