In order to evaluate the effect of training upon postoperative adhesions, standard bipolar and mechanical, nonopposing injuries were performed in the uterine horns and side walls of 52 mature female @entity95 using a conventional three-puncture laparoscopy, by an endoscopic surgeon with limited experience. An additional injury, either bipolar or mechanical or both, was performed in the retro-uterine space. With experience, the duration of surgery decreased progressively from 12 +/- 2 to 8 +/- 1 min in the first and last 10 animals respectively. The amount of perioperative @entity548 was not affected by experience. With experience the postoperative adhesions decreased in extent (P = 0.0001), tenacity (P = 0.004), type (P = 0.002) and @entity32 (P = 0.003) and for total score (P = 0.0002). These changes were correlated with the briefer duration of surgery but not with the amount of perioperative @entity548 . The strong correlations of adhesion scores in the pouch of Douglas, and around both uterine horns confirmed the importance of the inter-animal variability in making adhesions. By logistic regression, the adhesions in the pouch of Douglas were explained simultaneously by the adhesions on the uterine horns (P = 0.0004, thus correcting for inter-animal variability) by the amount of @entity548 (P = 0.01) and the duration of surgery (P = 0.05). No major differences were found in adhesions following a mechanical or a @entity162 or following such a lesion in the pouch of Douglas or at the uterine horns. In conclusion, experience, expressed by the duration of surgery and to a lesser extent perioperative @entity548 , is a major co-factor in postoperative adhesions, suggesting that duration of surgery should be strictly standardized in endoscopic adhesion studies. The important inter-animal variability can be circumvented by using a standard control lesion, making each animal its own control.

The effect of training and duration of surgery on adhesion formation in the XXXX model.

@entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity162 :: ('MESH:D001714', 'Disease') :: ['bipolar injury'] @entity95 :: ('9986', 'Species') :: ['rabbits'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding']
@entity95 :: (9986,Species) :: ['rabbit']
