7/25/2019 dr.hafez power point.pptx

1/14

STEPS TO REDUCE ADHESIONS

DURING SURGERY

Dr.Abdelhafz

TawalbehConsultant of Obstetrics andGynecology

7/25/2019 dr.hafez power point.pptx

2/14

Increase vascularpermeability

Reduce infection rate

Minimize tissue handling

Careful technique

Microsurgery

7/25/2019 dr.hafez power point.pptx

3/14

Reduce drying of tissues

Lubrication

Limit use of cautery

Limit use of sutures

Avoid materials ith !bres

"se of starch #free gloves

7/25/2019 dr.hafez power point.pptx

4/14

A$%&'IO('

)I*RI( $&+O'I,IO(

)ORMA,IO( O) A$%&'IO('

*leeding

in-ammation

7/25/2019 dr.hafez power point.pptx

5/14

Surgical procedures

on the:Ovary and tubes have

the highest ris. /01

)or Laparoscopicmyomectomy increase to

/23 244 procedures5

7/25/2019 dr.hafez power point.pptx

6/14

'ome studies shon thatadhesions6related

complications can occur tenyears after the initial surgicalprocedure5

738 of small boel obstructionare adhesion6related5

7/25/2019 dr.hafez power point.pptx

7/14

/41 of chronic pelvic pain arerelated to adhesions5

9:1 of repeat surgery ispotentially complicated byadhesions5

296741 of secondary infertility

7/25/2019 dr.hafez power point.pptx

8/14

+elvic pain is accounts for 241of Gynecological clinic visits5

"ltrasonography andLaparoscopy are the tool in theevaluation of undiagnosedchronic pelvic pain5

7/25/2019 dr.hafez power point.pptx

9/14

CLASSIFICATION OF

ADHESIONS:,hin !lmy

,hic. !brous adhesionscontaining blood vessels and

dense agglutination of nearlyall structures5

7/25/2019 dr.hafez power point.pptx

10/14

SITE OF ADHESIONS:

"pper abdomen

Mid abdomen

+elvis

Multiple 'ites

7/25/2019 dr.hafez power point.pptx

11/14

Adhesions ere the mostcommon pathology for pelvic

pain accounting for /46;

7/25/2019 dr.hafez power point.pptx

12/14

Adhesions that restrictthe free movement ofpelvic organs have beenimplicated as a cause of

chronic pelvic pain5

7/25/2019 dr.hafez power point.pptx

13/14

COM PLICATIONS OF ADHESIONS:

Intestinal obstruction

Infertility

Chronic pelvic pain

Loss of bone structure

7/25/2019 dr.hafez power point.pptx

14/14

,%A(>

?O"@@@