Page 14 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Chapter 1
In this thesis three topics will be discussed:
1. Which options do currently exist for postoperative adhesion
prevention and what role can a new anti-adhesive barrier
play?
2. What type of mesh for incisional hernia repair is preferable
when placed in the abdominal cavity?
3. Is there more evidence for chronic abdominal pain as
complication of abdominal adhesion formation?
Outline of thesis
Postoperative adhesion formation can be considered as the most frequent complication after abdominal surgery. The number of papers concerning this subject runs to thousands and multiple books have also been written (16). Consequently, it is almost impossible to address every aspect of this complex and wide-ranging subject.
In Chapter 2 a literature overview of the many different aspects of postoperative abdominal adhesion formation is presented.
In recent years, many studies have been performed in an attempt to find an effective adhesion prevention method following abdominal operations. Unfortunately, despite all efforts, no product has been adopted for general clinical use in abdominal surgery.
In Chapter 3 the results of an experiment with a new adhesion prevention barrier are presented.
In the past it has been shown that the use of an anti-adhesive barrier in the presence of a ‘fresh’ bowel anastomosis may result in an increase of anastomotic leakage (17). In this context it is essential that every new anti-adhesive agent has been tested in the presence of colonic anastomosis.
In Chapter 4 the effect of a new adhesion barrier, polyvinyl alcohol gel, on healing of colonic anastomoses is discussed.
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