Postoperative adhesions: From formation to prevention

Zeynep Alpay, Ghassan M. Saed, Michael P. Diamond

Research output: Contribution to journalReview articlepeer-review

130 Scopus citations


Postoperative intra-abdominal and pelvic adhesions are the leading cause of infertility, chronic pelvic pain, and intestinal obstruction. It is generally considered that some people are more prone to develop postoperative adhesions than are others. Unfortunately, there is no available marker to predict the occurrence or the extent and severity of adhesions preoperatively. Ischemia has been thought to be the most important insult that leads to adhesion development. Furthermore, a deficient, suppressed, or overwhelmed natural immune system has been proposed as an underlying mechanism in adhesion development. The type of surgical approach (laparoscopy or laparotomy) and closure of peritoneum in gynecologic surgeries and cesarean section have been debated as important factors that influence the development and extent of postoperative adhesions. In this article, we have reviewed the current state of adhesion development and the effects of barrier agents in prevention of postoperative adhesions.

Original languageEnglish (US)
Pages (from-to)313-321
Number of pages9
JournalSeminars in Reproductive Medicine
Issue number4
StatePublished - Jul 2008
Externally publishedYes


  • Adhesion barriers
  • Laparoscopy
  • Laparotomy
  • Peritoneal closure
  • Postoperative adhesions

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Reproductive Medicine
  • Endocrinology
  • Obstetrics and Gynecology
  • Physiology (medical)


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