Surgical adhesions among women undergoing laparoscopic gynecological surgery with or without adhesiolysis - prevalence, severity, and implications: retrospective cohort study at a University Hospital.

objectiveTo find out the prevalence of adhesions, severity, and their relation to the current clinical scenario and to the type of previous surgery. METHODS AND MATERIALS: A retrospective study of patients who already had different previous abdominopelvic surgery and subsequently underwent gynecological laparoscopic surgery for various indications. The patients' clinical and operative notes were reviewed and analyzed.

resultsThere were 654 procedures performed. The most common indication for the laparoscopic surgery was secondary infertility 23.5%, followed by adnexal lesions 22.0% and primary infertility 19.6%. Intraoperative adhesions were found in 45.3%. Adhesions were deemed relevant to the clinical scenario in 21.3%. Patients who had a previous history of open (traditional) surgery were more likely to be found with adhesions in comparison with patients with history of laparoscopic surgery (odds ratio: 2.7, 95% confidence interval: 1.4-5.3,

conclusionAdhesions were prevalent in gynecological patients with previous abdominopelvic surgery. They were a significant contributor to the gynecological and reproductive issues. To minimize the risk of postoperative adhesions, laparoscopic approach should be encouraged instead of traditional surgery and rates of cesarean section should be reduced. Further high-quality studies are needed to establish conclusion and practical guidance toward the use of adhesion barriers.