Related Experiment Videos
Prediction of intra-abdominal adhesions using the visceral slide test: A prospective observational study
Maria Lee1, Hee Seung Kim1, Hyun Hoon Chung1
1Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Objective:
The goal of this study was to determine whether the visceral slide test is an effective screening method for the prediction of intra-abdominal adhesions.
Study Design:
A prospective, observational study was conducted assessing a cohort of women undergoing benign gynaecologic surgery between April 2015 and June 2015. At the patient's preoperative visit, they underwent the ultrasound-based visceral slide test in five zones of the abdomen. The ultrasound assessments were validated against direct visualization during surgery. The effectiveness of the slide test as a screening technique was examined by recording the presence, extent, and severity of adhesions observed intraoperatively; this was scored using a modified version of the American Fertility Society (mAFS) system.
Results:
In total, 144 women completed the study, 33 (22.9%) of whom had previously undergone intra-abdominal surgery. The median time to perform the visceral slide test was 2min, and using our methodology, 48 patients (33.3%) were diagnosed with adhesions. We found that the visceral slide test had a sensitivity of 97.2%, specificity of 68.6%, positive predictive value of 90.6%, negative predictive value of 88.9%, and diagnostic accuracy of 90.3%. Further, the number of negative visceral slide tests was positively correlated with the mAFS scores.
Conclusion:
Our data suggest that the visceral slide test is a simple, fast, reliable assay for detecting intra-abdominal adhesions in patients undergoing gynaecologic surgery.