Adhesions Barrier Trial Advances at CWC&RS

Dr. Tom Lyons Says $20 Billion Scarring & Pain Problem a Major Cause of Infertility

Pelvic adhesions, the painful scar tissue that sometimes forms internally in reaction to surgery, contributes up to 40% of the cases of infertility in women. Dr. Tom Lyons, Medical Director and founder of the Center for Women’s Care & Reproductive Surgery in Atlanta, has launched a study on use of liquid barriers to prevent adhesions.

Adhesions barriers are used during the laparoscopic surgeries that Dr. Lyons performs to remove endometriosis or fibroids, to help stem this painful problem that costs $20 billion annually in the U.S. to correct. 

 “Adhesions are more likely to form with laparotomy, or longer incisions, because more tissue is disturbed in the process,” said Dr. Lyons. “Even though our patients very infrequently experience adhesive disease because we perform only laparoscopic surgery and the incisions are so small, we use this technique on every patient.”

“This study on adhesion barriers, along with the study we’re conducting with Olympus to visualize endometriosis more easily are both extremely important,” said Dr. Lyons, a gynecologic surgery pioneer who developed the Laparoscopic Supracervical Hysterectomy in 1989 and has taught it to surgeons around the world.

Adhesions develop after “nearly all” abdominal and pelvic procedures, and research has shown that the most common site for postsurgical adhesion development is the ovary.

“We’ve participated in studies on adhesion prevention numerous times over the years, and nothing has demonstrated success laparoscopically except Adept™ so far,” said Lyons.  Adept is a liquid and its actions may not be as effective to prevent ovarian adhesions specifically.

Patients have a pre-op and post-op pain inventory taken to determine the likelihood of whether painful adhesions have actually formed post-surgery. The adhesion barrier being studied will be used on ovaries, pelvic sidewalls, the anterior abdominal wall, which is where most adhesions form (over larger scars), and the uterus after myomectomy (fibroid removal).                                           

Other experts on adhesion prevention will also be involved in the study, viewing videos to discern adhesive disease. The experts reinforce that good surgical technique is key to minimize tissue injury, tissue devascularization and subsequent inflammation, the main causes of adhesion development.

In order to do this, said Dr. Lyons, surgeons must handle as little tissue as possible, keep tissues moist, be especially careful with the use of sutures, and use only very targeted electrosurgery and other energy sources to stop bleeding.

Patients seek Dr. Lyons from around the world for his advanced laparoscopic techniques, including surgical excision of endometriosis (removing it beneath the root so it does not grow back), pelvic floor reconstruction, reproductive and urinary leakage disorders.

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This page last updated 01/05/2012