Awareness of Post-Surgical Adhesions among Gynecological Surgeons: Focus on the Surgical Management of Endometriosis

Author(s):

Rudy Leon De Wilde*, Julio Alvarez, Hans Br�¶lmann, Ying Cheong, Pierre Collinet, Attilio Di Spiezio Sardo, Philippe Koninckx, Per Lundorff, Luz Angela Torres-de la Roche, Leszek Pawelczyk and Markus Wallwiener

Objective: Postoperative adhesions occur in 80% of cases of gynecological surgery. Therefore evidence-based recommendations have been made to improve surgeons´ knowledge of postoperative adhesion formation and preventive strategies. The objective of this survey was to assess the perceptions and practice of international gynecological surgeons on adhesions following endometriosis surgery. Materials and Methods: Data capture was conducted via online survey. The questionnaire was accessible worldwide during 2 weeks through the Society of Endometriosis and Uterine Disorders (SEUD) website. The qualitative variables were described as number and percent of the different response modalities, comparing European participants (n= 35) within the whole sample of surgeons (n= 65) vs non-European participants (n= 30). Results: 97% of Europeans and 63% of non-European surgeons recognize adhesion prevention as useful to reduce chronic postoperative pain and to avoid complications related to adhesions. To minimize adhesions, good surgical technique was considered relevant to almost all responders, also the use of anti-adhesive barriers or solutions (77% Europeans vs 57% non-European). 20% of all responders do not provide their patients with information about the risks of adhesion formation, related long-term complications or preventive treatment options. Conclusion: Despite a substantial awareness, disparities in daily practice of gynecological surgeons around the world facing the problem of adhesion formation in surgical endometriosis management exist. In order to improve adherence to anti-adhesion strategies in endometriosis surgery, more scientific evidence is needed. National and international scientific societies can play an important role to initiate research; also it might be helpful to call for more communication in this field.