Text based upon : see our publications
Koninckx PR, Gomel V. Introduction: Quality of pelvic surgery and postoperative adhesions. Fertil Steril. 2016;106:991-993
Koninckx PR, Gomel V, Ussia A, Adamyan L. Role of the peritoneal cavity in the prevention of postoperative adhesions, pain, and fatigue. Fertil Steril. 2016;106:998-1010.
Gomel V, Koninckx PR. Microsurgical principles and postoperative adhesions: lessons from the past. Fertil Steril. 2016;106:1025-1031.
Koninckx PR, Ussia A, Wattiez A, De Wilde RL. Laparoscopic management and prevention of pelvic adhesions and postoperative pain. In: Einarsson JI, Wattiez A, editors. Minimally invasive gynecologic surgery : Evidence based laparoscopic, hysteroscopic and Robotic surgeries. JP Medical limited, victoriastreet 83, London; 2016
Koninckx et al 2010 NEW CONCEPTS IN ADHESION PREVENTION : book chapter
Adhesions are a major clinical problem
Prevention is needed
since no cure for existing adhesions


Mechanism of adhesion formation
The old model of postoperative adhesions considers adhesion formation as a cascade of local processes between denuded areas. Either repair is rapid within a few days or adhesion formation starts
The new model of postoperative adhesions developed by our group has demonstrated that the acute inflammatory reaction in the peritoneal cavity is 20 times more important than this local process. The sum of all the good and bad factors will determine the degree of acute inflammation of the peritoneal cavity and thus of of postoperative adhesions.
Healing occurs within 3 days or adhesion formation starts


Classic Adhesion prevention
Classic
- good surgical practice = microchirurgical principles
- fast
- no blood loss
- gentle tissue handling
- prevent desiccation
- no unnecessary dissection
- Barriers : 40-50 efficacy
Conditioning even more important
- peritoneal conditioning
- after surgery
- cexamethasone
- a barrier
Conditioning : our experiments in the mouse model
We discovered the good and the bad factors


For this we received a series of awards
1st Prize
BELGIAN SOCIETY OF
REPRODUCTIVE MEDICINE
2001 Molinas et al
1st Prize ESGE R. Palmer Prize.
2001 Molinas et al
1st Prize ESHRE
PROMISING YOUNG SCIENTIST AWARD
2002 ESHRE Molinas et al
1st Prize ESGE
Cagliari
2004 Binda et al





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