Use of transabdominal ultrasound to identify intraabdominal adhesions prior to laparoscopy: a prospective blinded study

Overview: The aim of the current study was to assess the accuracy of transabdominal ultrasound (TAU) in identifying intra-abdominal adhesions (IAA) prior to laparoscopy in patients with previous abdominal surgery. Methods: Patients with previous open surgical procedures presenting for laparoscopic gastric bypass (LGB) underwent TAU by 1 radiologist. Attempts were made to identify IAA using TAU. The intended trocar sites were categorized as free movement (no adhesions), chaotic movement (omental adhesions), or no movement (frozen bowel). During LGB, adhesions at the 6 trocar sites were graded by 1 blinded surgeon. Results: A significant degree of agreement was found between the radiologist's predictions and the intraoperative findings with regards to identification of trocar sites free of adhesions versus omental adhesions and frozen bowel. Conclusions: TAU can accurately identify IAA prior to laparoscopy. Widespread application of this technique may decrease trocar-related injuries during laparoscopic procedures in patients with previous abdominal surgery.