Antiadhesive agents in laparoscopic surgery
Authors:
Ondřej Matěna
Authors‘ workplace:
Gynekologicko-porodnické oddělení, Nemocnice Vyškov, p. o., primář MUDr. Josef Eim
Published in:
Prakt Gyn 2013; 17(3): 237-240
Category:
Gynecology and Obstetrics: Review Article
Overview
Intraabdominal adhesions are the most frequent reason of abdominal pain and can cause many following problems as bowel obstruction, impair fertility or make reoperation difficult. As they generally result from previous laparoscopic procedure, every surgeon should try to prevent them. This article informs about genesis of peritoneal adhesions, treatment and focuses on new materials that can be used during the surgery to prevent its forming. As prevention is better than cure, care should be taken during the surgery via precise technique and no-harming procedures. Studies have proven that, among the methods approved to be used as a prophylaxis during the surgery, application of 100% hyaluronic acid gel or instillation of 4% icodextrin is the most efficient – resulting not only in less postoperative pain and discomfort but also, among females with severe endometriosis, in higher pregnancy rates after laparoscopic surgery. Barrier methods are efficient too, but the application is a little more complicated and more time-demanding. On the other hand, some procedures like instillation of heparin, NSAID, antibiotics or corticoids have been found un-efficient.
Key words:
adhesions – antiadhesives – adhesiolysis – icodextrin – hyaluronic acid – laparoscopy – peritoneal adhesions at females
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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Practical Gynecology
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