Advanced Surgery Adhesion Prevention

In a one year period from April 2021 to March 2022, The total cost to the NHS related to emergency treatment of SBO caused by adhesions was £44.8m.¹

From April 2021 to March 2022, 6,450 patients were admitted to hospital for conservative management of SBO costing £27m.¹ These patients stayed on average 8.64 days, costing £4,114 per patient.¹

From April 2021 to March 2022, 2,610 patients were admitted to hospital for adhesiolysis procedures for management of SBO costing £18.1m.¹

From April 2021 to March 2022, Patients receiving a procedure for adhesiolysis stayed on average 12 days in hospital, costing an average of £6,846 per patient.¹

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Publications on Adhesion Reduction

Adhesions are not preventable by surgical technique alone…

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Two male surgeons in the OR and one of them is asking for a tool

Minimise adhesions and protect your patients’ future

Perform meticulous haemostasis and irrigate to avoid blood deposits²
Minimise operating time²
Reduce trauma or damage to the serosa²
Reduce the risk of infection²
Reduce tissue drying²

Frequent irrigation during surgery³
Minimisation of the use of foreign bodies [e.g. swabs or suture material)²
Preferably use powder-free gloves for laparotomy²
Use humidified gases^2,4
Preferably use of minimally invasive techniques. There is no consensus in the
literature on whether laparoscopy results in less de novo and recurrent
adhesions than laparotomy⁸
Use of adhesion barriers²

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References

Baxter Healthcare Data on File. HES SBO Admission and treatment data April 2021 – March 2022 VANTAGE
Bruggmann D, Tchartchian G, Wallwiener M, Munstedt K, Tinneberg HR, Hackethal A. Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options. Dtsch Arztebl Int. 2010;107(44):769-775. doi:10.3238/arztebl.2010.0769
DeWilde RL, Trew G, on behalf of the Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE): Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2 - steps to reduce adhesions. Gynecol Surg 2007; 4: 243-53
Peng Y, Zheng M, Ye Q, Chen X, Yu B, Liu B: Heated and humidified CO2 prevents hypothermia, peritoneal injury, and intraabdominal adhesions during prolonged laparoscopic insufflations. J Surg Res 2009; 151: 40-47.
Menzies D, Ellis H. Intestinal obstruction from adhesions-how big is the problem? Ann R Coll Surg Engl. 1990;72{1 ):60-63.'
Gutt CN; Oniu T; Schemmer P; Mehrabi A; Buchler MW: Fewer adhesions induced by laparoscopic surgery? Surg Endosc 2004; 18: 898-906.
Lower AM, Hawthorn RJS, Clark D, Boyd JH, Finlayson AR, Knight AD et al {2004) Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24,046 patients. Hum Reprod 19:1877-1885
Ten Broek RP, Issa Y, van Santbrink EJ, Bouvy ND, Kruitwagen RF, Jeekel J, Bakkum EA, Rovers MM, van Goor H. Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis. Bmj. 2013 Oct 3;347.

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