Langenbeck's Archives of Surgery

, Volume 386, Issue 2, pp 141–145

Comparison of adhesion reformation after laparoscopic and conventional adhesiolysis in an animal model

Authors

  • A. Tittel
    • Department of Surgery, Technical University, Pauwelsstrasse 30, D-52074 Aachen, Germany
  • K.H. Treutner
    • Department of Surgery, Technical University, Pauwelsstrasse 30, D-52074 Aachen, Germany
  • S. Titkova
    • Department of Pathophysiology of the GI-Tract, Russian State University, Moscow, Russia
  • A. Öttinger
    • Department of Pathophysiology of the GI-Tract, Russian State University, Moscow, Russia
  • V. Schumpelick
    • Department of Surgery, Technical University, Pauwelsstrasse 30, D-52074 Aachen, Germany
Original Article

DOI: 10.1007/s004230000190

Cite this article as:
Tittel, A., Treutner, K., Titkova, S. et al. Langenbeck's Arch Surg (2001) 386: 141. doi:10.1007/s004230000190
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Abstract.

This study set out to compare adhesion reformation after conventional and laparoscopic adhesiolysis using two different laparoscopic dissection techniques. In a first operation, 36 rabbits underwent fixation of 6 cm2 of the cecum with the serosa removed to the lateral abdominal wall to induce standardized adhesions. After 4 weeks, adhesiolysis was performed laparoscopically (n=12) or via laparotomy (n=12) using sharp and blunt dissection. In a third group (n=12), laparoscopic adhesiolysis was performed using monopolar electrocautery. Outcome was assessed by incidence, extent, and localization of adhesion reformation. After conventional adhesiolysis, all rabbits developed new adhesions relative to 79% after laparoscopic adhesiolysis. The extent of reformed adhesions (median) was greater after conventional adhesiolysis than laparoscopic adhesiolysis (2725 mm2 vs 230 mm2, P<0.001). The latter did not differ significantly from laparoscopic adhesiolysis by electrocautery (310 mm2). There were small adhesions to 3 of 72 trocar wounds, but extensive adhesions to 33% of the abdominal incisions were found in the conventional group. In this standardized experimental setting, laparoscopic adhesiolysis is associated with a significantly reduced reformation of adhesions. Different laparoscopic dissection techniques have no significant influence on the extent of adhesion reformation.

Adhesion reformation Lapaparoscopic adhesiolysis Conventional adhesiolysis Comparative animal study
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© Springer-Verlag 2001