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Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2—steps to reduce adhesions

  • Review Article
  • Published:
Gynecological Surgery

Abstract

This consensus position represents the collective views of 35 gynaecologists with a recognised interest in adhesions. The first part of the position was presented in the previous issue of Gynecological Surgery and reviewed the published literature on the extent of the problem of adhesions. In this part, the opportunities to reduce their incidence are considered. Collective proposals on the actions that European gynaecologists should take to avoid causing adhesions are provided. Importantly, in this part, the need to now inform patients of the risks associated with adhesion-related complications during the consent process is discussed. With evidence increasing to support the efficacy of adhesion-reduction agents to complement good surgical practice, all surgeons should act now to reduce adhesions and fulfil their duty of care to patients.

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Acknowledgements

The consensus project and manuscript development was facilitated by Corvus Communications Limited under the direction of Rudy DeWilde and Geoffrey Trew. Special thanks go to the work of Alison Crowe, Alastair Knight and Jill Kirkdale in patiently supporting and encouraging all Adhesions Working Party members to actively contribute and feed back on all stages of the project development.

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Authors and Affiliations

  1. Department OBGYN, Pius-Hospital, Oldenburg, Germany

    Rudy Leon DeWilde

  2. Reproductive Medicine and Surgery, Hammersmith and Queen Charlotte’s Hospital, London, UK

    Geoffrey Trew

  3. Imperial College, University of London, London, UK

    Geoffrey Trew

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  1. Rudy Leon DeWilde
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  2. Geoffrey Trew
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On behalf of the Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE)

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Correspondence to Rudy Leon DeWilde.

Appendix

Appendix

Expert Adhesions Working Party of the ESGE

Members of the Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE) are listed below alphabetically. All members actively contributed to the development and review of the consensus paper, recognising the importance of publishing on a matter of such importance. The majority participated at the Adhesions Consensus Expert Workshop convened during the 15th Annual Congress of the ESGE and the project was progressed in accordance with accepted processes for the development of consensus statements (see Consensus Process including Conflict of Interest in part 1 published in the previous issue of Gynecological Surgery [86])

Prof. Rudy Leon DeWilde, Pius Hospital, Oldenburg, Germany

Mr. Geoffrey Trew, Hammersmith Hospital, London, UK

Dr. Stefano Angioni, H San Giovanni di Dio, Cagliari, Italy

Prof. Alain Audebert, Rue de Turenne, Bordeaux, France

Prof. Pedro Barri, Institut Universitari Dexeus, Barcelona, Spain

Prof. Charles Chapron, Clinique Universitaire Baudeloque, Paris, France

Prof. Maria Elisabetta Coccia, Ospedale di Careggi, Florence, Italy

Prof. Michel Degueldre, Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium

Prof. Gere diZerega, Keck School of Medicine, University of Southern California, Los Angeles, USA

Prof. Enrique Garcia, Instituto Valenciano de Oncologia, Valencia, Spain

Dr. Robert J S Hawthorn, Southern General Hospital, Glasgow, Scotland

Dr. Petra Janssen, Klinikum Konstanz, Konstanz, Germany

Prof. Philippe R Koninckx, University Hospital Gasthuisberg, Leuven, Belgium

Prof. Matthias Korell, Klinikum Duisburg, Wedau Kliniken, Duisburg, Germany

Dr. Stefano Landi, Ospedale Sacro Cuore, Verona, Italy

Mr. Adrian M Lower, The London Clinic, London, UK

Prof. Per Lundorff, Kvindeafdelingen, Viborg Sygehus, Denmark

Dr. Enda McVeigh, John Radcliffe Hospital, Oxford, UK

Prof. Patrick Madelenat, Hôpital Bichat, Paris, France

Prof. Valerio Mais, H San Giovanni di Dio, Cagliari, Italy

Prof. Gian Benedetto Melis, H San Giovanni di Dio, Cagliari, Italy

Prof. Luca Minelli, Ospedale Sacro Cuore, Verona, Italy

Prof. Carmine Nappi, Università degli studi di Napoli Federico II, Naples, Italy

Prof. Michelle Nisolle, University of Liege, Liege, Belgium

Prof. George Pados, Interbalkan European Medical Center (Diavalkanino), Thessaloniki, Greece

Prof. George Pistofidis, AKESO, Gynaecology & Reproductive Centre, Athens, Greece

Dr. Massimillano Pellicano, Università degli studi di Napoli Federico II, Naples, Italy

Prof. Jean Luc Pouly, Polyclinique de l'Hôtel-Dieu, Clermont-Ferrand, France

Prof. Stefan Rimbach, Klinikum Konstanz, Konstanz, Germany

Prof. Ernst Schmidt, Diakonie-Krankenhaus GmbH (Frauenklinik), Bremen, Germany

Prof. Christopher Sutton, The Guildford Nuffield Hospital, Guildford, UK

Dr. Alicia Ubeda, Institut Universitari Dexeus, Barcelona, Spain

Prof. Diethelm Wallwiener, Universitäts-Frauenklinik Tübingen, Tübingen, Germany

Prof. Arnaud Wattiez, IRCAD (Institut de Recherche contre les Cancers de l'Appareil Digestif), Hôpitaux Universitaires, Strasbourg, France

Prof. Errico Zupi, S. Giovanni calibita Fatebenefratelli Isola Tiberina, Rome, Italy

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DeWilde, R.L., 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 4, 243–253 (2007). https://doi.org/10.1007/s10397-007-0333-2

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