Adhesion prevention in gynecologic surgery

The impact of performing surgery on women of childbearing age is often underestimated. Particularly when we know that the number one cause of female infertility in the united states is Fallopian tube blockage/occlusion which is often caused by adhesions. A large proportion of pelvic pain in women is also often associated with adhesions. Even for women of non-childbearing age most bowel obstructions and other bowel complications occur as a result of adhesions.  Adhesion prevention starts even before the surgery with pre-operative planning, decisions regarding approach to surgery, decisions regarding energy use, and the intraoperative dissection of tissue are all important. There are also a number of adhesion barriers that are now available and may be useful in certain situations. This presentation will review the impact of adhesions on GYN surgery and methods of prevention during the pre-op planning, intra-op execution, and post-op care. Optimization of surgery in order to reduce adhesions will also be discussed and several available options will be reviewed.