Postoperative adhesion development after operative laparoscopy: evaluation at early second-look procedures. Operative Laparoscopy Study Group.

Abstract

To assess the issue of the frequency and severity of adhesion reformation and de novo adhesion formation after operative laparoscopy, this multicenter collaborative report of early second-look procedures after operative laparoscopy was initiated. Sixty-eight subjects underwent operative laparoscopic procedures including adhesiolysis, followed by a second operative procedure within 90 days. The total mean adhesion score decreased from 11.4 +/- 0.7 at the initial operative procedure to 5.5 +/- 0.4 at the second-look procedure, a decrease of 52%. At the time of the second-look procedure, 66 of 68 women (97.1%) had pelvic adhesions. Adhesion reformation occurred in 66 of 68 women and at 230 of 351 sites (66%) at which adhesions were lysed. Despite this high incidence of adhesion reformation, de novo adhesion formation after operative laparoscopy occurred in only 8 of 68 women (12%) and at 11 of 47 available sites in these 8 women. We conclude that adhesion reformation is a frequent occurrence after operative laparoscopy; however de novo adhesion formation appears to occur much less frequently.