Reduce and Prevent adhesions

Empowering surgeons to make the critical decisions that can impact longer, and healthier lives.

Since surgical treatment of adhesions is highly likely to be associated with the induction of new adhesions, reduction or prevention of adhesions should be every surgeon’s primary goal.

General strategies for preventing adhesions should be integrated into routine clinical practice. The use of commercially available peritoneal instillates or barrier techniques is particularly advisable in patients at high risk of developing adhesions.¹⁷

Adhesions are the most frequent complications of abdominal surgery.

Prof. Rudy Leon De Wilde, “The art of preventing adhesions in Surgery”, Baxter Advanced Surgery HemoVision webinars, June 2021.

Current Publications

Intestinal obstruction from adhesions—how big is the problem?

Menzies D et al.

Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options.

Brüggmann D et al.

Obstetrical outcome in the third trimester after hysteroscopic adhesiolysis.

Torres-de la Roche LA et al.

Adhesions after laparoscopic myomectomy: incidence, risk factors, complications, and prevention.

Herrmann A, et al.

Surgical adhesions: A sticky macrophage problem.

Herrick S et al.

A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery.

Torres-de la Roche LA et al.

Obstetrical outcome in the third trimester after hysteroscopic adhesiolysis.

Torres-de la Roche LA et al.

Becker JM, Dayton MT, Fazio VW, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg. 1996;183(4):297-306.
Menzies D, Ellis H. Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl. 1990;72(1):60-63.
Brüggmann D, Tchartchian G, Wallwiener M, Münstedt K, Tinneberg HR, Hackethal A. Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options. Dtsch Arztebl Int. 2010;107(44):769-775. doi:10.3238/arztebl.2010.0769
Diamond MP. Seprafilm Adhesion Study Group. Reduction of adhesions after uterine myomectomy by Seprafilm membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Fertil Steril. 1996;66(6):904-910.
Beck DE, Cohen Z, Fleshman JW, Kaufman HS, van Goor H, Wolff BG. Adhesion Study Group Steering Committee; A prospective, randomized, multicenter, controlled study of the safety of Seprafilm adhesion barrier in abdominopelvic surgery of the intestine. Dis Colon Rectum. 2003 Oct;46(10):1310-9.
Fazio VW, Cohen Z, Fleshman JW, et al. Reduction in adhesive small-bowel obstruction by Seprafilm adhesion barrier after intestinal resection. Dis Colon Rectum. 2006 Jan;49(1):1-11.
Tang C-L, Seow-Choen F, Fook-Chong S, Eu K-W. Bioresorbable adhesion barrier facilitates early closure of the defunctioning ileostomy after rectal excision: a prospective, randomized trial. Dis Colon Rectum 2003;46:1200–1207
Kusunoki et al. 2005 Masato Kusunoki1, Hiroki Ikeuchi2, Hidenori Yanagi2, Masafumi Noda2, Hitoshi Tonouchi1,Yasuhiko Mohri1, Keiichi Uchida1, Yasuhiro Inoue1, Minako Kobayashi1, Chikao Miki1, and Takehira Yamamura2 Bioresorbable Hyaluronate-Carboxymethylcellulose Membrane (Seprafilm) in Surgery for Rectal Carcinoma: A Prospective Randomized Clinical Trial Surg Today (2005) 35:940–945
Attard, Jo-Anne et al. “Adhesive small bowel obstruction: epidemiology, biology and prevention.” Canadian Journal of Surgery. 2007 Aug; 50(4); 291-300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386166/
Fushiki, H, Tomomi Ikoma, Hiroto Kobayashi, Hideo Yoshimoto. Efficacy of Seprafilm as an adhesion prevention barrier in Cesarean Sections.OB-GYN Surgery.Obstretic and Gynecological Treatment (Japanese publication). 91(5):557-561, Special Edition 2005 November.
Catena, F., De Simone, B., Coccolini, F. et al. Bowel obstruction: a narrative review for all physicians. World J Emerg Surg 14, 20 (2019). https://doi.org/10.1186/s13017-019-0240-7
Nahirniak P, Tuma F. Adhesiolysis. [Updated 2020 Dec 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563219/
Fushiki H, Yuki H, Nakajima A. Usefulness of Seprafilm during a cesarean section. Ob Gyn Surgery [Japanese]. 2002:99-105.
Bates GW Jr, Shomento S. Adhesion prevention in patients with multiple cesarean deliveries. Am J Obstet Gynecol. 2011 Dec;205(6 Suppl):S19-24. doi: 10.1016/j.ajog.2011.09.030. Epub 2011 Oct 6. PMID: 22114994.
Shunichiro Tsuji, Kentaro Takahashi, Hiroko Yomo, Mutsuko Fujiwara, Nobuyuki Kita, Koichi Takebayashi, Kohji Miyazaki, Yoichi Noda, Effectiveness of antiadhesion barriers in preventing adhesion after myomectomy in patients with uterine leiomyoma, European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 123, Issue 2, 2005, Pages 244-248, ISSN 0301-2115, https://doi.org/10.1016/j.ejogrb.2005.04.012.
Robertson D, Lefebvre G; CLINICAL PRACTICE GYNAECOLOGY COMMITTEE. Adhesion prevention in gynaecological surgery. J Obstet Gynaecol Can. 2010 Jun;32(6):598-602. English, French. doi: 10.1016/S1701-2163(16)34530-3. PMID: 20569542.
Brüggmann D, Tchartchian G, Wallwiener M, Münstedt K, Tinneberg H-R, Hackethal A: Intra-abdominal adhesions—definition, origin, significance in surgical practice, and treatment options. Dtsch Arztebl Int 2010; 107(44): 769–75. DOI: 10.3238/arztebl.2010.0769
Gutt CN; Oniu T; Schemmer P; Mehrabi A; Buchler MW: Fewer adhesions induced by laparoscopic surgery? Surg Endosc 2004; 18: 898–906.
Peng Y, Zheng M, Ye Q, Chen X, Yu B, Liu B: Heated and humidified CO2 prevents hypothermia, peritoneal injury, and intraabdominal adhesions during prolonged laparoscopic insufflations. J Surg Res 2009; 151: 40–47.
Bryant T. Clinical lectures on intestinal obstruction. Med Times Gaz 1872;1:363-5.
Fruin AB, Bishop-Bartolomei KK, et al.: Neurokinin-1 receptor and substance P messenger RNA levels increase during intraabdominal adhesion formation. J Surg Res 2002; 108: 165–72.
von Dembowski T: Über die Ursachen der peritonealen Adhäsionen nach chirurgischen Eingriffen mit Rücksicht auf die Frage des Ileus nach Laparotomien. Langenbecks Arch Chir 1889; 37: 745.
Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL: Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Dig Surg 2001, 18: 260–73.
Cheong YC, Laird SM, Li TC, Shelton JB, Ledger WL, Cooke ID: Peritoneal healing and adhesion formation/reformation. Human Reprod Update 2001; 7: 556–66.
Monk BJ, Berman ML, Montz FJ: Adhesions after extensive gynecologic surgery: clinical significance, etiology and prevention. Am J Obstet Gynecol 1994; 170: 1396–1403.
Monk BJ, Berman ML, Montz FJ: Adhesions after extensive gynecologic surgery: clinical significance, etiology and prevention. Am J Obstet Gynecol 1994; 170: 1396–1403.
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Hackethal A, Sick C, Brueggmann D, Tchartchian G, Wallwiener M, Muenstedt K, Tinneberg HR. Awareness and perception of intra-abdominal adhesions and related consequences: survey of gynaecologists in German hospitals. Eur J Obstet Gynecol Reprod Biol. 2010 Jun;150(2):180-9. doi: 10.1016/j.ejogrb.2010.02.017. Epub 2010 Mar 16. PMID: 20236750.
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ten Broek RP, Issa Y, van Santbrink EJ, et al. Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis. BMJ.
Sarah e. Herrick, Judith e. Allen Surgical adhesions: A sticky macrophage problem, Science05 mar 2021 : 993-994
Lower AM, Hawthorn RJS, Clark D, Boyd JH, Finlayson AR, Knight AD et al (2004) Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24,046 patients. Hum Reprod 19:1877–1885
DeWilde RL, Trew G, on behalf of the Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE): Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2 – steps to reduce adhesions. Gynecol Surg 2007; 4: 243–53.
Diamond MP, Freeman ML (2001) Clinical implications of postsurgical adhesions. Hum Reprod Update 7:567–576
ten Broek RP, Bakkum EA, Laarhoven CJ, van Goor H. Epidemiology and Prevention of Postsurgical Adhesions Revisited. Ann Surg. 2016 Jan;263(1):12-9. doi: 10.1097/SLA.0000000000001286. PMID: 26135678.
Herrick SE, Allen JE. Surgical adhesions: A sticky macrophage problem. Science. 2021 Mar 5;371(6533):993-994. doi: 10.1126/science.abg5416. PMID: 33674481.

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Reduce and Prevent adhesions

Empowering surgeons to make the critical decisions that can impact longer, and healthier lives.

Since surgical treatment of adhesions is highly likely to be associated with the induction of new adhesions, reduction or prevention of adhesions should be every surgeon’s primary goal.

General strategies for preventing adhesions should be integrated into routine clinical practice. The use of commercially available peritoneal instillates or barrier techniques is particularly advisable in patients at high risk of developing adhesions.¹⁷

Current Publications

Intestinal obstruction from adhesions—how big is the problem?

Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options.

Obstetrical outcome in the third trimester after hysteroscopic adhesiolysis.

Adhesions after laparoscopic myomectomy: incidence, risk factors, complications, and prevention.

Surgical adhesions: A sticky macrophage problem.

A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery.

Obstetrical outcome in the third trimester after hysteroscopic adhesiolysis.

Empowering surgeons to make the critical decisions that can impact longer, and healthier lives.

Since surgical treatment of adhesions is highly likely to be associated with the induction of new adhesions, reduction or prevention of adhesions should be every surgeon’s primary goal.

General strategies for preventing adhesions should be integrated into routine clinical practice. The use of commercially available peritoneal instillates or barrier techniques is particularly advisable in patients at high risk of developing adhesions.17

Current Publications

Intestinal obstruction from adhesions—how big is the problem?

Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options.

Obstetrical outcome in the third trimester after hysteroscopic adhesiolysis.

Adhesions after laparoscopic myomectomy: incidence, risk factors, complications, and prevention.

Surgical adhesions: A sticky macrophage problem.

A new approach to avoid ovarian failure as well function-impairing adhesion formation in endometrioma infertility surgery.

Obstetrical outcome in the third trimester after hysteroscopic adhesiolysis.

General strategies for preventing adhesions should be integrated into routine clinical practice. The use of commercially available peritoneal instillates or barrier techniques is particularly advisable in patients at high risk of developing adhesions.¹⁷