Table 2.

Adhesion-reduction steps

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 hemostasis but ensure diligent use of cautery

Reduce cautery time and frequency and aspirate aerosolized 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 nonreactive sutures

Avoid foreign bodies - such as materials with loose fibers

Minimal use of dry towels or sponges in laparotomy

Use starch- and latex-free gloves in laparotomy

Based on: De Wilde and Trew[46]