None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
INTRODUCTION Adhesion formation is the most common complication following  peritoneal surgery  and the leading cause of small bowel obstruction , acquired infertility and inadvertent organ injury at reoperation .
Using a ' good surgical technique ' is advocated as a first step in preventing adhesions .
However , the evidence for different surgical techniques to reduce adhesion formation needs confirmation .
Electrocautery causes more ischemic peritoneal tissue damage than ultrasonic dissection
Background Minimizing peritoneal tissue injury during abdominal surgery has the benefit of reducing postoperative inflammatory response , pain , and adhesion formation .  Ultrasonic dissection seems to reduce tissue damage . This study aim ed to compare electrocautery and ultrasonic dissection in terms of peritoneal tissue ischemia measured by microdialysis . Methods In this study , 18 Wistar rats underwent a median laparotomy and had a peritoneal microdialysis catheter implanted in the left lateral sidewall . The animals were r and omly assigned to receive two st and ard peritoneal incisions parallel to the catheter by either ultrasonic dissection or electrocautery . After the operation , sample s of microdialysis dialysate were taken every 2 h until 72 h postoperatively for measurements of pyruvate , lactate , glucose , and glycerol , and ratios were calculated . Results The mean lactate – pyruvate ratio ( LPR ) , lactate – glucose ratio ( LGR ) , and glycerol concentration were significantly higher in the electrocautery group than in the ultrasonic dissection group until respectively 34 , 48 , and 48 h after surgery . The mean areas under the curve ( AUC ) of LPR , LGR , and glycerol concentration also were higher in the electrocautery group than in the ultrasonic dissection group ( 4,387 vs. 1,639 , P = 0.011 ; 59 vs. 21 , P = 0.008 ; 7,438 vs. 4,169 , P = 0.008 , respectively ) . Conclusion Electrosurgery causes more ischemic peritoneal tissue damage than ultrasonic dissection
None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
INTRODUCTION Adhesion formation is the most common complication following  peritoneal surgery  and the leading cause of small bowel obstruction , acquired infertility and inadvertent organ injury at reoperation .
Using a ' good surgical technique ' is advocated as a first step in preventing adhesions .
However , the evidence for different surgical techniques to reduce adhesion formation needs confirmation .