Epidemiological, Clinical, and Surgical Outcomes of Laparoscopic Surgery for Postoperative Adhesions : A Retrospective Study at Panzi General Reference Hospital

Introduction: Peritoneal adhesions represent a major clinical challenge in digestive surgery and are currently the most common complication of abdominal surgery and one of the biggest unresolved problems in colorectal
surgery to date.

Methodology: This is a descriptive study with retrospective data collection on postoperative adhesions observed in patients who underwent laparoscopic surgery between January 1, 2023, and August 31, 2024, at
the Panzi General Reference Hospital in North Kivu, Democratic Republic of Congo.

Results: Adhesions were observed in 73 of the 103 patients with a history of laparotomy who underwent laparoscopic surgery, representing a frequency of 70.87%. The median age was 42 years. The sex ratio was 11.1, with a predominance of females. 79.45% of patients had one to three previous surgeries in their history. Cesarean section, laparotomy, and appendectomy were the most frequently cited previous surgeries. The most common indications were infertility and lithiasiccholecystitis. The intraoperative findings revealed the presence of lithiasiccholecystitis and uterine fibroids. The most common types of adhesions were adhesions between the omentum and the wall. Adhesiolysis was performed in 91.78% of cases. The median operating time was 92.5 minutes, ranging from 25 to 165 minutes. The conversion rate was 1.37%. In 90.41% of cases, no intraoperative incidents were reported.

Conclusion: Postoperative adhesions remain common in our setting. They generally require intraoperative adhesiolysis. The conversion rate is low and acceptable. Laparoscopic management reduces postoperative morbidity. Widespread use of minimally invasive surgery will reduce the occurrence of adhesions in surgery.

Keywords: Laparoscopic Surgery, Postoperative Adhesions.