Adhesion prevention in gynecologic surgery

Togas Tulandi, Tulandi T, Abdulaziz Al-Shahrani, Abdulaziz Alshahrani, Al-Shahrani A
Current opinion in obstetrics & gynecology · 2005 · vol. 17(4) , pp. 395–398 · doi:10.1097/01.gco.0000175357.25932.89 · PMID:15976545 · W2028103780
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This review examines new substances and techniques, like hydrogels and hyaluronic acid, and surgical approaches, such as laparoscopy and temporary oophoropexy, for preventing post-surgical adhesions in gynecologic procedures.

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Abstract

PURPOSE OF REVIEW: The purpose of this review is to discuss new substances and techniques to prevent post-surgical adhesion formation. RECENT FINDINGS: Intraperitoneal administration of sprayable hydrogel and hyaluronic acid appears to decrease postmyomectomy adhesions. Intrauterine instillation of auto-crosslinked hyaluronic acid is associated with fewer intrauterine adhesions. Temporary abdominal oophoropexy after surgery of stage III and IV endometriosis might be beneficial in reducing ovarian adhesion. SUMMARY: There has been a wide range of adhesion-reducing substances evaluated in animal models. However, in clinical situations, no adhesion-preventing substance, material, or barrier is unequivocally effective. In view of surgical technique, compared to laparotomy, the laparoscopic approach is associated with less adhesion formation. Temporary abdominal oophoropexy may provide a promising technique to prevent ovarian adhesions. Future research should also be directed toward preventing intrauterine adhesions.
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Adhesion prevention in gynecologic surgery - Togas Tulandi - Abdulaziz Al-Shahrani Purpose of review The purpose of this review is to discuss new substances and techniques to prevent post-surgical adhesion formation. Recent findings Intraperitoneal administration of sprayable hydrogel and hyaluronic acid appears to decrease postmyomectomy adhesions. Intrauterine instillation of auto-crosslinked hyaluronic acid is associated with fewer intrauterine adhesions. Temporary abdominal oophoropexy after surgery of stage III and IV endometriosis might be beneficial in reducing ovarian adhesion. Summary There has been a wide range of adhesion-reducing substances evaluated in animal models. However, in clinical situations, no adhesion-preventing substance, material, or barrier is unequivocally effective. In view of surgical technique, compared to laparotomy, the laparoscopic approach is associated with less adhesion formation. Temporary abdominal oophoropexy may provide a promising technique to prevent ovarian adhesions. Future research should also be directed toward preventing intrauterine adhesions.

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Condition tags

endometriosis

MeSH descriptors

Genital Diseases, Female Gynecologic Surgical Procedures Postoperative Complications Animals Female Genital Diseases, Female Gynecologic Surgical Procedures Humans Hyaluronic Acid Hydrogel, Polyethylene Glycol Dimethacrylate Postoperative Complications Tissue Adhesions Tissue Adhesions Vitamin E

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