INTERGEL@ Adhesion Prevention Solution CLINICAL EXPERTS CONSENSUS REPORT ON SAFETY AND EFFECTIVENESS April 29,200l

INTRODUCTION j Postsurgical adhesions are a highly prevalent complication of abdominal and pelvic surgery,” generating significant morbidity. In major gynecologic surgery, post-operative adhesions are estimated to occur at a rate of 60-90% (Monk et al. 1994), with at least 15 20% of female infertility cases attributed to pelvic adhesions (Milingos et al. 2OOOb, Drollette and Badawy 1992). Postsurgical adhesions are the largest single cause of intestinal obstruction. From 30 to 41% of bowel obstruction surgery is due to adhesions, with 6575% of these cases in the small bowel (Menzies 1993; Ellis 1998) Some cases of chronic pelvic pain are likely to be attributable to postsurgical adhesions, based on data from 11 studies in which this was the most common pathology observed (40% of cases) (see Holmdahl et al. 1997). However, well-designed studies in support of pelvic pain as a complication of postsurgical adhesions are lacking to date.