Table 1 Adhesion-reduction steps

Carefully handle tissue with field enhancement (magnification) techniques

Focus on planned surgery and, if any secondary pathology is identified, question the risk benefit of surgical treatment before proceeding

Perform diligent haemostasis but ensure diligent use of cautery

Reduce cautery time and frequency and aspirate aerosolised tissue following cautery

Excise tissue—reduce fulguration

Reduce duration of surgery

Reduce pressure and duration of pneumoperitoneum in laparoscopic surgery

Reduce risk of infection

Reduce drying of tissues (limit heat and light)

Use frequent irrigation and aspiration in laparoscopic and laparotomic surgery

Limit use of sutures and choose fine non-reactive sutures

Avoid foreign bodies—such as materials with loose fibres

Minimal use of dry towels or sponges in laparotomy

Use starch- and latex-free gloves in laparotomy