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Updated: Aug 14, 2026
A Translational Surgical Porcine Model for Postoperative Intra-Abdominal Adhesion Formation
Published on: March 13, 2026
Postoperative adhesion formation after laparoscopic uterine horn resection in a porcine model: comparison of five
Yutaka Hirota1, Kazuhiko Tsukada, Eiji Nishio
1Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Aichi, Japan. yhirota@fujita-hu.ac.jp
Purpose:
To evaluate the postoperative adhesion formation caused by instruments used in gynecologic laparoscopic surgery and to determine the optimal instruments to use to reduce adhesions.
Materials And Methods:
Seventeen juvenile pigs underwent laparoscopic bilateral resection of the uterine horns under general anesthesia and pneumoperitoneum. The laparoscopic procedures were carried out using monopolar electrocautery (ME) (n = 8), an electrothermal bipolar vessel sealer (EBVS) (n = 6), an ultrasonically activated scalpel (UAS) (n = 6), a loop-type ligature (LTL) with a steel scalpel for severing the tissues (n = 6), and an automatic stapling device (ASD) (n = 8). Second- look laparotomy was performed 14 days postoperatively, and the degree of postoperative adhesions was scored from 0 to 6.
Results:
The mean and range of adhesion scores were 0.00 with EBVS, 0.13 (range, 0-1) with ASD, 0.33 (range, 0-2) with LTL, 1.17 (range, 0-3) with UAS, and 3.13 (range, 2-6) with ME. We found a statistically significant difference in the extent of postoperative adhesion formation associated with these 5 instruments (P < 0.001, Kruskal-Wallis test).
Conclusion:
Adhesion formation increased in the order EBVS < ASD < LTL < UAS < ME. Our study strongly suggests that surgical instruments can be selected to reduce postoperative adhesion formation, a particular concern in women of reproductive age.
