***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Pelvic adhesions are found in up to 50 % of women with CPP during investigative surgeries and adhesiolysis is often performed as part of their management although the causal or casual association of adhesions , and the clinical benefit of adhesiolysis in the context of CPP is still unclear . Our aim was to test the hypothesis of whether laparoscopic adhesiolysis leads to significant pain relief and improvement in quality of life ( QoL ) in patients with chronic pelvic pain ( CPP ) and adhesions . Methods This was a double-blinded RCT . This study was conducted in 2 tertiary referral hospitals in United Kingdom over 4 years . Women with chronic pelvic pain ( CPP ) were r and omized into having laparoscopic adhesiolysis or diagnostic laparoscopy .  Women were assessed at 0 , 3 and 6 months for Visual analogue scale scores ( VAS ) and Quality of Life ( QoL ) measures ( SF-12 and EHP-30 ) . Results A total of 92 participants were recruited ; 50 qualified to be r and omized , with 26 in the adhesiolysis and 24 in the control group . The results are expressed in median ( interquartile ranges ) . In women who underwent adhesiolysis , there was a significant improvement at 6 months in VAS scores ( -17.5 ( -36.0 - -5.0 ) compared to controls ( -1.5 ( -15.0 – 4.5 ; p = 0.048 ) ; SF-12 scores physical component score ( 25.0 ( 18.8 – 43.8 ) ) compared to controls ( 6.3 ( -6.3 – 18.8 ) ; p = 0.021 ) , SF-12 emotional component score 32.5 ( 4.4 – 48.8 ) compared to controls -5 ( -21.3 – 15.0 ) ; p < 0.0074 ) and EHP-30 emotional well being domain 32.5 ( 4.4 – 48.8 ) compared to the controls -5 ( -21.3 – 15.0 ; p < 0.0074 ) . Conclusions This study stopped before recruitment reached the statistically powered sample size due to difficulty with enrollment and lack of continued funding . In selected population of women presenting to the gynecological clinic with chronic pelvic pain , adhesiolysis in those who have adhesions may be of benefit in terms of improvement of pain and their quality of life . Trial registration numberIS RCT N Abstract  Intraperitoneal ( IP ) ventral hernia repair  has been proposed with the advantages of reducing dissection , operative time , and postoperative pain . The IP position of the mesh is suspected of increasing the risk of visceral adhesion and inducing complications . To overcome these drawbacks , a mesh protected on one side by a hydrophilic resorbable film ( Parietex Composite ) has been vali date d [ 1 ] . Using a previously described ultrasound procedure [ 2 ] , the purpose of this study was to compare the rate of visceral adhesion after intraperitoneal placement of a polyester mesh versus this protected mesh .  Fifty-one patients who received a Parietex Composite mesh were prospect ively compared to a retrospective series of 22 consecutive asymptomatic patients who received a Mersilene mesh .  To objective ly assess visceral adhesion toward the abdominal wall , an ultrasound ( US ) specific examination was firstly vali date d and secondly used to evaluate the adhesion incidence in both groups . Both groups were equivalent in terms of inclusion criteria and body mass index ( BMI ) . Pre-operative US versus perioperative macroscopical findings determined the following parameters : sensitivity 83 % , accuracy 78 % , negative predictive value 81 % . Using this procedure , 77 % of the patients exhibited visceral adhesion to the mesh in the Mersilene group , against 18 % in the Parietex Composite group ( P<0.001 , chi-square ) . US examination represents a suitable tool to evaluate postoperative adhesions to the abdominal wall . Using this procedure , a significant reduction of visceral adhesion in the Parietex Composite group was shown Study Objective : Introduce a non-invasive method preoperatively to prevent bowel injury by the Veres needle and trocar during laparoscopy . Design : Case-controlled study . Setting : A hospital-based study . Patients : Five hundred and twelve patients who underwent laparoscopic surgery were prospect ively enrolled . Intervention : A simple and non-invasive method to detect bowel adhesions preoperatively . Results : A total of 512 patients who underwent operative laparoscopy  were prospect ively enrolled for ultrasonographic visceral sliding evaluation . They were subdivided into two groups as follows : group I , 332 patients without previous abdominal surgery ; group II , 180 patients with previous abdominal surgery .  No bowel adhesion to the umbilicus was present in group I. In group II , only two cases with bowel adhered to the periumbilical area were found by visceral sliding technique . No patients suffered any bowel injury . Conclusion : The proposed technique is useful and highly effective in guiding the insertion of the Veres needle and trocar to prevent bowel injury in laparoscopy Intraperitoneal positioning of conventional parietal mesh provides efficient reconstruction but causes visceral adhesion formation in 80–100 % of the cases . The purpose of this clinical trial was to assess the performance and tolerance of a new generation of polyester mesh protected by a hydrophilic resorbable film . Eighty patients were included in a prospect i ve multicenter clinical trial . Patients were treated for ventral hernia via an open approach ( 64 % ) or laparoscopically ( 36 % ) . All meshes were implanted in a midline intraperitoneal location . The main objective was to evaluate the anti-adhesive capability of the mesh in relation to the viscera . In order to assess the absence of visceral adhesion objective ly , an ultrasound ( US ) specific examination was initially vali date d ( pre-operative prediction vs. per-operative findings ) and then used during the follow-up . The usual clinical parameters were also collected to follow the patients on a period up to 4 years . Pre-operative US prediction vs. per-operative macroscopic findings : sensitivity 79 % , overall accuracy 76 % , negative predictive value 85 % . After 12 months , 86 % of the patients were ultrasonically adhesion free . Early post-operative complications were : seroma/hematoma ( 16 % ) , subcutaneous infection ( 4 % ) , cutaneous necrosis ( 1 % ) and occlusions ( outside the mesh ) ( 2.5 % ) . No mortality was reported . Clinical ly , after 12-month follow-up , no complication related to post-operative adhesions to the mesh was noted : ( occlusion 0 % , fistula 0 % ) . Late complications were : mesh sepsis ( 1 % ) , new defects ( 4 % ) and recurrence ( 2.5 % ) . Finally , 56 patients ( 75.7 % ) were clinical ly evaluated with a mean follow-up of 48±6 months . One direct recurrence was noted while six patients experienced new defect outside the mesh . No long-term severe complication such as occlusion or enterocutaneous fistula was observed . Based on a mean clinical follow-up of 4 years , the results of this prospect i ve multicenter clinical trial demonstrate the safety and the efficiency of this composite mesh in the intraperitoneal treatment of incisional and umbilical hernia . In particular there was no early or long-term main complication due to the intraperitoneal location of the mesh The risk of visceral injury during laparoscopy occurs mainly during the creation of the pneumoperitoneum and the insertion of the first trocar and is substantially greater in patients with a previous history of laparotomic surgery or peritonitis , owing to the possible presence of abdominal wall adhesions . In this study we assessed the results of preoperative ultrasonography of the parietal wall for the diagnosis of peritoneal adhesions , through the detection of two signs unrelated to one another , for the purpose of minimizing the number of false-negative results . Ultrasonography of the parietal wall was performed preoperatively in 130 patients who had previously undergone laparotomy .  The ultrasound results were transcribed in the form of a map of the abdominal wall and checked during laparoscopy . The overall diagnostic accuracy was 88.5 % , the specificity was 31.8 % , and the sensitivity was 100 % . The hazardous laparoscopic maneuvers were performed in adhesion-free areas in all cases , and there were no cases of complications due to visceral injury Viscera slide is the normal , longitudinal movement of the intraabdominal viscera caused by respiratory excursions of the diaphragm . By detecting areas of restricted viscera slide , ultrasonic imaging was used to identify anterior abdominal wall adhesions prior to laparotomy or laparoscopy . Transcutaneous ultrasound examination was performed on 110 patients . A prediction of adhesions was made for each patient and then compared to the findings during subsequent laparotomy or laparoscopy .  Only patients with previous abdominal surgery or history of peritonitis demonstrated adhesions . Sensitivity and specificity of viscera slide ultrasound in predicting adhesions were 90 % and 92 % . Nine out of 10 false results involved misinterpretation of ultrasound images of the lower one-third of the abdomen . Ultrasonic imaging of viscera slide is highly accurate in detecting abdominal wall adhesions . This technique is most useful in guiding the insertion of trocar in laparoscopic surgery , and as a noninvasive method in study ing the formation of adhesions Background Abdominal surgery , peritonitis , and pelvic inflammatory disease often give rise to intra-abdominal adhesions . They may lead to chronic pain , infertility , bowel obstruction , etc . Development in surgical strategies in the last decade has result ed in an increase in laparoscopic procedures and , as a consequence , a steep rise in reported bowel lesions . Accordingly , noninvasive diagnostic tools are desirable to identify adhesions before abdominal surgery . This study was design ed to vali date transabdominal ultrasonography ( TAU ) and magnetic resonance imaging ( cine MRI ) for detection of abdominal wall adhesions . Methods Sixty patients scheduled for laparoscopic surgery were prospect ively enrolled . They were divided into two groups of 30 each ; previous abdominal surgery/peritonitis and no history of abdominal surgery/peritonitis . Before elective surgery , TAU and cine MRI were performed . Visceral slide was measured in nine predefined abdominal segments and compared with intra-operative data on abdominal wall adhesions . Results were obtained in a double-blinded fashion . Results Patient characteristics were similar in both groups . Cine MRI showed a sensitivity , specificity , and accuracy of 21.5 % , 87.1 % , and 72.4 % . TAU showed a sensitivity , specificity , and accuracy of 24 % , 97.9 % , and 81.3 % . Comparison of TAU and cine MRI showed no significant difference in the detection of adhesions to the abdominal wall ; however , TAU was significantly superior in depicting adhesion-free areas . Conclusions This study represents the first comparative study of TAU and cine MRI as noninvasive methods in detecting adhesions to the abdominal wall . Both methods are specific in detecting adhesion-free areas , and may serve as a diagnostic tool for future planning of laparoscopic surgery , elucidation of adhesion-related symptoms , and as a tool in the follow-up after ventral hernia repair with implantation of intraperitoneal mesh Goal : Our aim was to assess the long-term efficacy of diagnostic laparoscopy and adhesiolysis on the treatment of intractable chronic abdominal pain .  Study : This was a prospect i ve nonr and omized study of 72 patients ( 60 women and 12 men ) . One surgeon performed a total of 79 diagnostic laparoscopies including 61 adhesiolysis . The patients ' demographic data , operative findings , and long-term postoperative course were carefully recorded . A  quality -of-life question naire was mailed after the mean follow-up of 3.7 years to find out the late course of any chronic abdominal symptoms after the surgery . Results : Intra-abdominal adhesions were found in 61 patients ( 85 % ) in the laparoscopy , gynecologic disorders in 4 , chronic appendicitis in 1 , and no abnormality in 6 patients . The abdominal wall pain was a likely reason for pain in 12 patients ( 17 % ) . The complication rate was minimal , including only four bleedings ( one major ) , one perforation of urinary bladder , and three wound infections . At 1-month control , 38 % of the patients were completely free of pain . In the long-term follow-up , chronic abdominal pain was totally healed in 33 % , diminished in 46 % , and unchanged in 21 % of the patients . A total of 65 patients ( 90 % ) reported that the surgery had been beneficial for their intractable pain . Conclusions : By careful selection , for patients with chronic abdominal pain , laparoscopy alleviates the symptoms in more than 70 % of the patients , and it should be considered if other diagnostics tests are negative . A placebo-controlled study is needed , in which the patients are r and omized into laparoscopy and conservatively treated groups with a quality -of-life measurement STUDY OBJECTIVE To estimate the feasibility of preoperative ultrasound evaluation 
    Output:
    
Conclusions Currently , abdominal US can be used to determine the presence of adhesions between bowel and the abdominal wall .
MRI is also an accurate diagnostic modality and can in addition visualize adhesions between viscera , however , with a tendency to over diagnose adhesions .
There is insufficient evidence to support CT as a diagnostic modality for adhesions