Table 1.

Steps to reduce adhesions, from [36]

• Carefully handle tissue with field enhancement (magnification) techniques

• Focus on planned surgery and, if any secondary pathology is identified, question the risk/benefit of surgical treatment before proceeding

• Perform diligent haemostasis but ensure diligent use of cautery

• Reduce cautery time and frequency and aspirate aerosolised tissue following cautery

• Excise tissue—reduce fulguration

• Reduce duration of surgery

• Reduce pressure and duration of pneumoperitoneum in laparoscopic surgery

• Reduce risk of infection

• Reduce drying of tissues (limit heat and light)

• Use frequent irrigation and aspiration in laparoscopic and laparotomic surgery

• Limit use of sutures and choose fine non-reactive sutures

• Avoid foreign bodies—such as materials with loose fibres

• Minimise the use of dry towels or sponges in laparotomy

• Use starch- and latex- free gloves in laparotomy