*5.1.2.6 Release adhesion to surrounding organs*

Lysis of adhesions can be performed as a part of the various procedures in abdominal cavity. Adhesiolysis is releasing adhesions either by blunt or sharp dissection

#### **Figure 4.**

*Clamp and cut left round ligament. The round ligament is grasped with forceps at its proximal and distal portion and transected.*

**Figure 5.** *Opening retroperitoneal space to identify ureter.*

during surgery. The standard method of removing adhesions using "blunt dissection" is to pull adhesions apart with gentle traction during surgery. The main principles of adhesion prevention and complications are minimizing surgical trauma and could use adjuvants to reduce adhesion formation. Adhesiolysis can be done during laparoscopy or open laparotomy. In case of severe and extensive adhesion would be safer with open laparotomy. Severe adhesion between uterus and bowel during open laparotomy (**Figures 7–9**).

#### **Figure 6.**

*Clamp and cut infundibulo-pelvic ligament after identified ureter.*

**Figure 7.** *(a) Fibrin adhesiolysis in laparoscopy. (b) Adhesiolysis in open laparotomy.*
