Post-operative abdominal adhesions—awareness of UK gynaecologists—a survey of members of the Royal College of Obstetricians and Gynaecologists

With the recent publication of the European Society of Gynaecological Endoscopy consensus position on adhesion reduction, all members of the Royal College of Obstetricians and Gynaecologists were sent a postal survey with the aim to understand and benchmark UK gynaecological surgeons’ attitudes and actions on adhesions. As expected, of the 356 who responded, gynaecological surgeons (72%) were the majority. Over 85% of respondents agreed that adhesions develop after any type of gynaecological surgery, and more than 50% considered adhesions were now the most common complication of abdominal surgery. Approximately four out of five respondents agreed that all gynaecological patients should be informed of the risk of adhesions and 61% noted that they routinely inform patients for all or some procedures. However, written information was only provided by 2.3% of respondents. Importantly, respondents agreed that a routine adhesion reduction strategy with good surgical technique was fundamental. Respondents’ use of specific agents was identified with 78.8% relying on surgical technique as their current strategy. While 78.8% would use an anti-adhesion agent in high-risk surgery—only 6.1% would consider use in all surgery. Most surgeons still rely on surgical technique alone as their anti-adhesion strategy despite increasing evidence of the important potential additional benefits of using anti-adhesion agents.