Incidence of intraabdominal adhesions in a continuous series of 1000 laparoscopic procedures

• Published in: American journal of obstetrics and gynecology Vol. 203; no. 2; pp. 111.e1 - 111.e3
• Main Authors: Dubuisson, Jean, Botchorishvili, Revaz, Perrette, Sandrine, Bourdel, Nicolas, Jardon, Kris, Rabischong, Benoît, Canis, Michel, Mage, Gérard
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.2010; Elsevier
• Subjects: Abdominal Cavity - surgery; adhesion formation; Adult; Age Distribution; Biological and medical sciences; Cohort Studies; Digestive system. Abdomen; Endoscopy; Female; Follow-Up Studies; France; Gynecology. Andrology. Obstetrics; Humans; Incidence; Intestinal Diseases - epidemiology; Intestinal Diseases - etiology; Intestinal Diseases - surgery; Investigative techniques, diagnostic techniques (general aspects); laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Laparotomy - adverse effects; Laparotomy - methods; Laparotomy - statistics & numerical data; Medical sciences; Middle Aged; Obstetrics and Gynecology; Postoperative Complications - epidemiology; Postoperative Complications - physiopathology; prior laparotomy; Probability; Prospective Studies; Reoperation; Risk Assessment; Tissue Adhesions - epidemiology; Tissue Adhesions - etiology; Tissue Adhesions - surgery; Treatment Outcome; France; laparoscopy; prior laparotomy; adhesion formation; Gynecology; Laparoscopy; Endoscopy; Epidemiology; Adhesion; Obstetrics; Incidence
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2010.03.031

The objective of the study was the laparoscopic evaluation of the incidence of intraabdominal adhesions related to prior abdominal surgery. This was a prospective monocentric study including a continuous series of 1000 gynecologic laparoscopic procedures. Data were collected on history of abdominal surgery. A precise initial description of intraoperative adhesions was performed. Six hundred thirty-seven of the 1000 procedures (63.7%) were performed in patients with a history of 1 or more than 1 abdominal surgery. Intraoperative adhesions were found in 211 of the 1000 subjects (21.10%). Fifty-nine of the 211 cases (28%) involved bowel loops. The prior indication for surgery did not seem to influence adhesion formation. The rate of intestinal adhesions significantly increased with the number of prior abdominal surgeries. The rate of intestinal adhesions was significantly higher in cases of prior midline incisions in comparison with the other incisions. Extensive preoperative knowledge of prior surgery is essential to evaluate the risk of adhesion formation.