Does prior cesarean section increase the risk of periumbilical adhesions in total laparoscopic hysterectomy?

Creative Commons License

Bölükbaşı M., Bölükbaşı F., Kantarcı S., Kanmaz A. G., Töz E., İnan A. H.

Wideochirurgia I Inne Techniki Maloinwazyjne, cilt.21, sa.2, ss.191-196, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 21 Sayı: 2
  • Basım Tarihi: 2026
  • Doi Numarası: 10.20452/wiitm.2026.18035
  • Dergi Adı: Wideochirurgia I Inne Techniki Maloinwazyjne
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), East & Central Europe Database (ProQuest), Health Research Premium Collection (ProQuest)
  • Sayfa Sayıları: ss.191-196
  • Anahtar Kelimeler: cesarean section, laparoscopic entry, periumbilical adhesions, total laparoscopic hysterectomy, visceral slide
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

INTRODUCTION Periumbilical adhesions may complicate laparoscopic entry and increase the risk of intraoperative injury, yet the isolated effect of prior cesarean section (CS) remains unclear. AIM We aimed to evaluate the association between a history of CS and periumbilical adhesions in total laparoscopic hysterectomy, and assess the value of the visceral slide. MATERIALS AND METHODS A total of 100 patients undergoing total laparoscopic hysterectomy were enrolled and divided into 2 groups: individuals with a history of CS and those with no prior abdominal surgeries. Preoperative visceral slide and intraoperative adhesion assessment were performed. Perioperative outcomes were recorded and a multivariable analysis was conducted. RESULTS Adhesions were more frequent in the CS group (22% vs 10%; P = 0.06) than the individuals without a history of abdominal surgery. A history of CS was not an independent predictor of adhesions (odds ratio, 0.468; P = 0.23). No major entry-related complications occurred. Perioperative outcomes were similar between the groups. The visceral slide showed low sensitivity (25%) but high specificity (100%). CONCLUSIONS A history of CS alone does not significantly increase periumbilical adhesions or compromise entry safety in total laparoscopic hysterectomy. Routine modification of the entry strategy may not be necessary. The visceral slide is useful for confirming adhesions, but does not exclude them.