Evaluation of Adhesions Underneath Laparoscopic Sterilization Scar in Patients Undergoing Abdominal Surgery
Ravi Singh Dogra
Department of Surgery, Civil Hospital Ghumarwin, HP, India.
Sanjeev Kumar
Department of Surgery, Dr. R.P. Govt. Medical College Kangra, Tanda, HP, India.
Som Raj Mahajan
Department of Surgery, Dr. R.P. Govt. Medical College Kangra, Tanda, HP, India.
Rajesh Chaudhary
Department of Surgery, Dr. R.P. Govt. Medical College Kangra, Tanda, HP, India.
Poonam Dogra
Department of Anesthesia, Dr. R.P. Govt. Medical College Kangra, Tanda, HP, India.
Vikrant Dharwal
Department of Surgery, Zonal Hospital Mandi, HP, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: The minimally invasive approach has become the method of choice for treating most benign abdominal diseases that require surgery. However, it is obvious that laparoscopic procedures are not risk free. The aim of this study was to evaluate the prevalence of intra abdominal adhesions underneath umbilical scar following laparoscopic sterilization, in patients who are undergoing abdominal surgeries.
Materials and Methods: The present study was a hospital based prospective observational study conducted in the Department of Surgery, Dr Rajendra Prasad Government Medical College (Dr. RPGMC), Kangra at Tanda (HP). The study group consisted of patients admitted to department of surgery during a period of one year and who fulfilled inclusion criteria. During intraoperative period, they were examined for presence or absence of adhesions at the site of previous laparoscopic sterilization scar at Periumblical area.
Results: Total of 60 patients were taken in this study. Two out of 60 (3.3%) patients had adhesions underneath previous Laparoscopic Sterilization scar around umbilicus and adhesive structure was omentum in both cases.
Conclusion: Adhesion formation is expected in any abdominal surgery whether open or laparoscopic surgery. In our study only 3.3% of patients had adhesions underneath previous laparoscopic sterilization scar in periumblical region. Therefore umbilical port can be considered for re-entry of index port in next laparoscopic surgery, in patients with history of laparoscopic surgery through umbilical region.
Keywords: Abdominal surgery, laparoscopic sterilization, portsite adhesions, umbilical scar.