Prevention of adhesions

For a complete text : download Postoperative adhesions and their prevention an article that will be published shortly.

Postoperative adhesions are an important clinical problem

Adhaesions occur in 80% after surgery and are are

a major cause of chronic pain, although pain intensity may be variable

a major cause of infertility

almost all bowel obstructions are caused by adhesions

Some 30% of women need a reintervention probably because of adhesions within 10 years

Pathophysiology

a local process Traditionally adhesions are considered to form between 2 opposing lesions after surgery.
The peritoneal cavity as a cofactor Our group has been very active in the research of adhesion formation and its prevention. Our major discovery was besides the local trauma, the peritoneal cavity is a major cofactor in adhesion formation. This is quantitatively the most important. We identified as important factors

the duration of surgery : slow surgeons have more adhesions)
trauma during surgery : less experienced surgeons have more adhesions
dessication of the mesothelial cells
temperature of the pneumoperitoneum
the gaz mixture used for pneumoperitoneum : addition of 4% of oxygen is beneficial.
the the amount of bleeding during surgery.

Prevention of adhesion formation

We expect that in a short time surgery , virtually without adhesions will become realistic with what we called combination therapy.