Gynecologic Adhesions Not Reduced by Laparoscopic Surgery

A new study has found that women undergoing common gynecologic procedures with laparoscopic surgery are just as likely to be re-admitted for treatment of surgery-related adhesions as women who had open surgery. The findings were presented at the annual meeting of the European Society of Human Reproduction and Embryology in Madrid (Spain).

Researchers identified more than 24,000 patients in Scotland who had gynecologic and lower abdominal laparotomies between April 1996 and March 1997, and then tracked all re-admissions in the subsequent four years. They found that although the risk of adhesion-related re-admission was very low for laparoscopic sterilization procedures, it was significant in other laparoscopic procedures. The highest risk of adhesion-related re-admissions was found to follow operations on the ovary and Fallopian tubes.

About 93% of patients undergoing abdominal surgery develop adhesions, which are implicated in up to 20% of cases of secondary infertility. Many doctors had hoped that less-invasive surgery with laparoscopic techniques would help to lower the risk of adhesions and thereby reduce the associated rate of infertility.

"What our research shows, however, is that adhesion prevention strategies must be adopted even during laparoscopic procedures since in many gynecologic procedures, re-admission due to adhesion-related complications is just as common as with open surgery,” said Adrian Lower, M.D., principal investigator and consultant gynecologist at the London Clinic (UK).




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