Comparison of adhesion formation in open and laparoscopic surgery

The development of postoperative adhesions remains an almost inevitable consequence of visceral and gynecological surgery, appearing in 50-95% of all patients. The pathogenetical sequence from peritoneal injury, with locally released cytokines and inflammatory reaction, to permanent fibrous adhesions has been elucidated in recent years. Early and late bowel obstruction, chronic abdominal pain, and infertility are the main clinical complications, and they also increase the socio-economic costs. Laparoscopic surgical procedures with their minimal access to the abdominal cavity are associated with fewer postoperative adhesions compared to open surgery, although adhesion formations cannot be entirely prevented.