Reduction, Regrowth, and de novo Formation of Abdominal Adhesions after Laparoscopic Adhesiolysis: A Prospective Analysis

Aim: A significant reduction of abdominal adhesions at second-look relaparoscopy after adhesiolysis in patients with chronic abdominal pain. Methods: 368 patients underwent laparoscopic adhesiolysis because of chronic abdominal pain. Regrowth and de novo abdominal adhesions were determined in a qualitative and quantitative way in 24 patients who underwent a second-look re-laparoscopy because of recurrent pain after a mean period of 16 months after the first laparoscopic adhesiolysis. Reduction of incidence, extent, type, and severity of abdominal adhesions between organs and abdominal wall and de novo adhesion formation were determined. Results: Incidence (40 vs. 26), extent, type, and severity of abdominal adhesions between organs and abdominal wall are significantly reduced after laparoscopic adhesiolysis. After adhesiolysis of adhesions between organs themselves, no significant reduction could be demonstrated (incidence 40 vs. 32). De novo adhesions were present in 5 (5/24) patients. Conclusion: Laparoscopic adhesiolysis results in a significant reduction of adhesions between organs and abdominal wall, despite the occurrence of de novo adhesions in about 20% of the patients.

[1]  J. Jeekel,et al.  Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial , 2003, The Lancet.

[2]  W. Hop,et al.  A Prospective Analysis of Predictive Factors on the Results of Laparoscopic Adhesiolysis in Patients with Chronic Abdominal Pain , 2003, Surgical laparoscopy, endoscopy & percutaneous techniques.

[3]  J. Jeekel,et al.  Safe laparoscopic adhesiolysis with optical access trocar and ultrasonic dissection , 2002, Surgical Endoscopy And Other Interventional Techniques.

[4]  J. Jeekel,et al.  Complications and feasibility of laparoscopic adhesiolysis in patients with chronic abdominal pain , 2002, Surgical Endoscopy.

[5]  L. Stassen,et al.  Fewer Intraperitoneal Adhesions With Use of Hyaluronic Acid–Carboxymethylcellulose Membrane: A Randomized Clinical Trial , 2002, Annals of surgery.

[6]  M. Ivarsson,et al.  Response of visceral peritoneum to abdominal surgery , 2001, The British journal of surgery.

[7]  M. Parker,et al.  Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study , 1999, The Lancet.

[8]  W. Richards,et al.  Adhesion formation is reduced after laparoscopic surgery , 1999, Surgical Endoscopy.

[9]  M. Schäfer,et al.  Experimental study of adhesion formation in open and laparoscopic fundoplication , 1998, The British journal of surgery.

[10]  M. Schäfer,et al.  Comparison of Adhesion Formation in Open and Laparoscopic Surgery , 1998, Digestive Surgery.

[11]  C. Chapron,et al.  Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. , 1998, Human reproduction.

[12]  M. Hashizume,et al.  Needle and trocar injury during laparoscopic surgery in Japan , 1997, Surgical Endoscopy.

[13]  J. Jeekel,et al.  Reduction of intraperitoneal adhesion formation by use of non‐abrasive gauze , 1997, The British journal of surgery.

[14]  B. Risberg.  Adhesions: preventive strategies. , 1997, The European journal of surgery. Supplement. : = Acta chirurgica. Supplement.

[15]  L. Holmdahl.  The role of fibrinolysis in adhesion formation. , 1997, The European journal of surgery. Supplement. : = Acta chirurgica. Supplement.

[16]  S. Stryker,et al.  Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. , 1996, Journal of the American College of Surgeons.

[17]  S. Wexner,et al.  Adhesion formation after laparoscopic anterior resection in a porcine model: a pilot study. , 1996, Surgical laparoscopy & endoscopy.

[18]  J. Jeekel,et al.  Foreign material in postoperative adhesions. , 1996, Annals of surgery.

[19]  Robert G. Moore,et al.  Adhesion formation after transperitoneal nephrectomy: laparoscopic v open approach. , 1995, Journal of endourology.

[20]  D. Hunt,et al.  Is laparoscopy associated with a lower rate of postoperative adhesions than laparotomy? A comparative study in the rabbit. , 1995, The Australian and New Zealand journal of surgery.

[21]  R. Stephens,et al.  A prospective randomized trial of laparoscopic versus open appendectomy. , 1992, Surgery.

[22]  K. Semm.  Pelviscopic Surgery: A Key for Conserving Fertility , 1991, Annals of the New York Academy of Sciences.

[23]  R. D. de Wilde.  Goodbye to late bowel obstruction after appendicectomy. , 1991, Lancet.

[24]  E. Lorenz,et al.  Pathophysiologie und Klassifikation von Adhäsionen , 1990 .

[25]  H. Ellis.  The causes and prevention of intestinal adhesions , 1982, The British journal of surgery.