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 .
Effectiveness of autocrosslinked hyaluronic acid gel after laparoscopic myomectomy in infertile patients: a prospective, randomized, controlled study.
OBJECTIVE To assess the efficacy of autocrosslinked hyaluronic gel in postsurgical adhesion prevention after laparoscopic myomectomy . DESIGN Prospect i ve , r and omized , controlled study . SETTING University of Naples " Federico II".Thirty-six infertile women with symptomatic myomas were r and omly divided into two groups of 18 patients each . INTERVENTION(S ) Laparoscopic myomectomy with subserous sutures or interrupted figure 8 sutures , with ( group A ) or without ( group B ) application of autocrosslinked hyaluronic acid ( HA ) gel . MAIN OUTCOME MEASURE(S ) Rate of postsurgical adhesions at 60 - 90 days of follow-up . The rate of subjects who developed postoperative adhesions was significantly lower in group A in comparison with group B ( 27.8 % vs. 77.8 % ) . In both groups , the rate of adhesions was significantly higher in patients treated with interrupted figure 8 sutures than with subserous sutures . CONCLUSION ( S ) Autocrosslinked HA gel is a promising resorbable agent barrier for the reduction of postoperative adhesions after laparoscopic myomectomy . Moreover , the type of suture is a factor influencing the postsurgical adhesion formation
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 .