Adhesiolysis

Lysis of adhesions improves pregnancy rates. Results of laparoscopic lysis are not different from those of laparotomy. Since laparoscopy is more convenient to the patient, less expensive, saves hospital beds, and involves low morbidity, it should be the preferred surgical approach to the diagnosis and treatment of pelvic adhesions whenever possible. The use of a sharp dissection combined with electrocautery seems, at this time, to be equally effective to the use of lasers of different kinds. Adjuvants presently available, especially Hyskon or INTERCEED, have an added benefit to surgery alone. Even with the best surgical technique, adhesions tend to re-form. Although SLL will identify the extent of adhesion re-formation, the therapeutic advantage of lysing re-formed adhesions is yet to be proved.