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World J Gastroenterol. May 7, 2014; 20(17): 4917-4925
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.4917
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.4917
Peritoneal adhesions after laparoscopic gastrointestinal surgery
Valerio Mais, Division of Gynecology, Obstetrics and Pathophysiology of Human Reproduction, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
Author contributions: Mais V solely contributed to this paper.
Supported by University of Cagliari, Italy, through the CAR Fund for 2012
Correspondence to: Valerio Mais, MD, PhD, Associate Professor, Division of Gynecology, Obstetrics and Pathophysiology of Human Reproduction, Department of Surgical Sciences, University of Cagliari, Ospedale “San Giovanni di Dio”, Via Ospedale 46, 09124 Cagliari, Italy. gineca.vmais@tiscali.it
Telephone: +39-70-652797 Fax: +39-70-668575
Received: October 28, 2013
Revised: January 11, 2014
Accepted: February 16, 2014
Published online: May 7, 2014
Revised: January 11, 2014
Accepted: February 16, 2014
Published online: May 7, 2014
Core Tip
Core tip: Laparoscopy reduces de novo adhesion formation but does not reduce adhesion reformation. Adhesion reduction does not necessarily impact clinical outcomes. CO2 pneumoperitoneum causes peritoneal inflammation depending on the insufflation pressure and surgery duration. Broad peritoneal cavity protection by insufflating a low-temperature, humidified gas mixture of CO2, N2O, and O2 seems to represent the best approach for reducing peritoneal inflammation due to CO2 pneumoperitoneum. A global strategy to prevent adhesion formation following laparoscopy should combine broad peritoneal cavity protection with the local application of a barrier.