Adhesion prevention in gynecologic surgery

The purpose of this review is to discuss new substances and techniques to prevent post-surgical adhesion formation.

Intraperitoneal administration of sprayable hydrogel and hyaluronic acid appears to decrease postmyomectomy adhesions. Intrauterine instillation of auto-crosslinked hyaluronic acid is associated with fewer intrauterine adhesions. Temporary abdominal oophoropexy after surgery of stage III and IV endometriosis might be beneficial in reducing ovarian adhesion.

There has been a wide range of adhesion-reducing substances evaluated in animal models. However, in clinical situations, no adhesion-preventing substance, material, or barrier is unequivocally effective. In view of surgical technique, compared to laparotomy, the laparoscopic approach is associated with less adhesion formation. Temporary abdominal oophoropexy may provide a promising technique to prevent ovarian adhesions. Future research should also be directed toward preventing intrauterine adhesions.