Postoperative adhesion formation after urological laparoscopy in the pediatric population.

The risk of intraperitoneal adhesion formation is a concern with transperitoneal laparoscopic surgery. To evaluate the incidence of adhesions after interventional urological laparoscopy, we reviewed 41 pediatric patients who had undergone second-look procedures. The number of adhesions and quantitation of the degree of each adhesion were assessed. Major laparoscopic procedures were performed previously in 8 patients, moderate in 29 and minor in 4. Adhesions were noted in 4 patients (9.8%), including 2 adhesions at the operative site and 2 at trocar sites. The risk of adhesions increased with the extent of dissection. Two adhesions developed after major procedures but the grade and extent of these adhesions were minimal. In the majority of patients re-peritonealization occurred with minimal or no scarring noted. Although adhesions may occur with pediatric urological laparoscopic procedures, the incidence appears lower than what one would expect with open exploration.