**2.14. Complications**

8 Enhancing Success of Assisted Reproduction



The incidence and severity of adhesions


With an optimal surgical technique intending to minimize mesothelial injury, peritoneal trauma is inevitable. laparoscopy leads to less adhesion formation compared to open surgery.

Adhesiolysis is essential to restore normal tubo-ovarian anatomical relationships. The basic principles for carrying out adhesiolysis are followed: If the adhesion is thin and avascular, it is easily lysed and the chances of recurrence are not much. If adhesion is thick and highly vascular it is difficult to separate. Theses adhesion requires use of energy (Unipolar or Bipolar, Ultrasonic dissector). After achieving haemostasis sharp dissection with scissors are necessary. After adhesiolysis some fluid can be left inside to prevent recurrence or high molecular weight dextran tried to prevent re-adhesion. The fertility results after adhesiolysis

The most commonly used agents for preventing postoperative adhesions:


Causes of pelvic adhesions







Prevention of adhesions in surgery

**2.12. Adhesion Prevention Techniques** 



**2.13. Laparoscopic adhesiolysis** 

are correlated with the state of the adhesions.


The most common intraoperative complication is injury to the bowel. With dense adhesions, this risk increases. Other intraoperative complications may include bleeding and injury to adjacent organs such as the gallbladder, spleen, ovaries, especially when working next to these organs-
