IS LAPAROSCOPY ASSOCIATED WITH A LOWER RATE OF POSTOPERATIVE ADHESIONS THAN LAPAROTOMY - A COMPARATIVE-STUDY IN THE RABBIT

This trial set out to test the hypothesis that there is no difference in the incidence of intra-abdominal adhesions after a stereotyped intr aperitoneal injury created via laparoscopy or laparotomy. Twenty New Z ealand White rabbits had a 2 x 2 cm area of peritoneum stripped off th eir caecum and adjacent parietal peritoneum, either by laparotomy or l aparoscopy. Outcome was assessed by the incidence of adhesions to the test site and the wound. There was no difference in the rate of adhesi ons at the test site in the two groups. The rate of adhesions to the w ound was different in the two groups (70% laparotomy, 0% laparoscopy; P = 0.003). In a rabbit model, comparing laparoscopy and laparotomy in a strictly controlled operative environment, a stereotyped intraperit oneal injury results in similar rates of postoperative adhesions. Lapa roscopy is, however, associated with a much lower incidence of wound a dhesion. The potential for postoperative adhesions is real after lapar oscopic surgery.