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 .
Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial.
OBJECTIVE To evaluate the fertility outcome after laparoscopic surgery for ectopic pregnancy . DESIGN A r and omized trial versus laparotomy was performed between May 1987 and June 1989 . SETTING The study was conducted in a clinical university center , the Sahlgrens Hospital . PATIENTS A group of 105 patients with tubal pregnancy were stratified with regard to risk determinants and age and r and omized to laparoscopy or laparotomy .  Eighty-seven patients who desired pregnancy were evaluated for subsequent fertility outcome . INTERVENTIONS Linear salpingotomy was performed in both surgical groups . MAIN OUTCOME MEASURE We evaluated the fertility outcome after laparoscopic salpingotomy for comparison with the outcome after laparotomy . RESULTS There was no difference between the groups in the overall fertility outcome . A substantially higher proportion of patients in the laparotomy group were subjected to adhesiolysis performed at a second-look laparoscopy . CONCLUSIONS The fertility prospect s are not impaired by laparoscopic surgery . Adhesiolysis at a second-look laparoscopy , especially after laparotomy , might be beneficial in selected cases and may serve to improve subsequent fertility
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 .