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Adhesion Prevention in Operative Laparoscopy

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Objective: To know the modalities used for prevention of adhe¬sion formation in operative Japaroscopy.
Method: Literature study.
Results: Methods of prevention of adhesion in laparoscopy in-clude: modification of surgical technique, anti-inflammatory agents, peritoneal instillates and barrier adjuvants. Modification of surgical techniques such as adherence to basic principles of microsurgery, the use of electrothermal bipolar vessel sealer, liberal irigation of the abdominal cavity and instillation of a large amount of Ringer's lactate at the completion of the procedure. This technique alone, eventhough seems effective, is insufficient. The anti-inflammatory agents used are the NSAIDs, corticosteroids, antihistamines, pro¬gestogens, GnRH agonists and calcium channel blocker. But none of them demonstrated to be significantly effective. Barrier adjuvants consist of: oxidized regenerated cellulose (ORC) and expanded po¬Iytetrafluoroethylene (ePTFE) and peritoneal instillates are the crys¬talloids, icodextrin, hyaluronic acid (HA), solution of HA, viscoe¬lastic gel, hydrogel, and fibrin sealent. There is insufficient evidence data regarding the metaods above for the prevention of adhesioge¬nesis in laparoscopy. But one study evaluating the use of viscoelas¬tic gel did significantly reduce adnexal adhesion in laparoscopy.
Conclusion: Laparoscopy does not trully eliminate the adhesio-genesis problem. No single therapy is effective for prevention of ad¬hesion formation. The multimodal methods shall be used to increase the successful rate in adhesion prevention.
[Indones J Obstet Gynecol201O; 34-4: 204-7]

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Detail Information

Series Title

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Call Number

Majalah Obstetrics dan Ginekologi Indonesia;34(4)2

Publisher

Jakarta : Indonesian Society of Obstetrics and Gynecology., 2010

Collation

3p,

Language

English

ISBN/ISSN

0303-7924

Classification

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Content Type

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Media Type

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Carrier Type

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Edition

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Subject(s)

adhesions
LAPAROSCOPY

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