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 .
Peritoneal fibrinolytic response to various aspects of laparoscopic surgery: a randomized trial.
BACKGROUND Peritoneal fibrinolysis is important in peritoneal wound healing processes and adhesion formation . The peritoneal fibrinolytic response to laparoscopy is merely unknown . In the present study we investigate the effect of short-term laparoscopy on the peritoneal fibrinolytic response and the influence of intra-abdominal pressure , light intensity and choice of dissection device on this response . METHODS There were 50 patients scheduled for laparoscopic cholecystectomy r and omized in five groups operated with various pressures , light intensities , and dissection devices .  Peritoneal biopsies were taken at the beginning and the end of the procedure . Tissue concentrations of tissue-type plasminogen activator ( tPA ) , urokinase-type plasminogen activator ( uPA ) , plasminogen activator inhibitor type 1 ( PAI-1 ) , and the tPA-activity were measured using ELISA techniques . RESULTS There were no differences in tPA antigen , tPA-activity , uPA antigen , or PAI-1 antigen concentrations in biopsies taken at the beginning compared to sample s taken at the end of the operation . Different intra-abdominal pressures , light intensities and the choice dissection device did not affect any of the measured parameters . CONCLUSION Short-term laparoscopy does not affect the peritoneal fibrinolytic activity . The used intra-abdominal pressure , light intensity and choice of dissection device do not affect peritoneal activity during short-term laparoscopy
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 .