[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436902-105":59,"doc-detail-436902-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","pelvic-adhesion-a-challenge-of-all-gynecologic-surgeries","Pelvic adhesion - A challenge of all gynecologic surgeries","","Pelvic adhesions arise from fibrin deposition and can progress through hemostasis, inflammation, proliferation, and remodeling, ultimately forming fibrous tissue connections that may cause chronic pain, bowel obstruction, functional impairment, and infertility. Intra-abdominal and pelvic adhesions are most commonly related to prior surgeries. Management can require adhesiolysis when complications such as obstruction or recurrent disease occur. Minimally invasive approaches are discussed, including hysteroscopic, laparoscopic, and robotic techniques, with emerging evidence questioning “contraindication” assumptions in patients with surgical histories.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pelvic-adhesion-a-challenge-of-all-gynecologic-surgeries/436902/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pelvic-adhesion-a-challenge-of-all-gynecologic-surgeries/436902.png","ImageObject",300,407,{"name":92,"@type":93},"Rizky","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What are pelvic adhesions and how do they develop?","Question",{"text":113,"@type":114},"Pelvic adhesions are fibrous tissue connections formed after fibrin deposition during internal healing and inflammatory processes across multiple overlapping phases.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why are pelvic and intra-abdominal adhesions particularly common?",{"text":118,"@type":114},"They are mainly caused by surgeries, far more often than by severe infection or inflammatory reactions.",{"name":120,"@type":111,"acceptedAnswer":121},"How do minimally invasive approaches relate to adhesions and adhesiolysis?",{"text":122,"@type":114},"Surgical adhesiolysis is sometimes necessary, but minimally invasive hysteroscopic, laparoscopic, and robotic options are frequently preferred; evidence suggests adhesions are not necessarily a contraindication for minimally invasive surgery.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},436902,1791004335,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},962085564807,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","J Chin MedAssoc  \nEditorial  \nPelvic adhesion: A challenge of all gynecologic surgeries  \nYiu-Tai Lia, Chia-Hao Liub,c, Peng-Hui Wangb,c,d,e,*  \naDepartment of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cInstitute of Clinical Medicine, National Yang Ming Chiao Tung University Taipei, Taiwan, ROC; dFemale Cancer Foundation, Taipei, Taiwan, ROC; eDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC  \nAdhesions, characterized by fibrin deposition leading to fibrous tissue connections (adherence tissues) between various tissue planes or organs, as part of internal healing process and inflammatory reactions passing through the different but overlapping phases (hemostasis/inflammatory phase, proliferative phase, and remodeling phase), are usually the defense mechanisms against the various causes of inflammation (physical, chemical, infections, etc.), resulting in unfavorable consequences, such as chronic pain, obstruction (especially bowel), function impairment, and infertility.1–4 Intra-abdominal and pelvic adhesion are by far the most common of all adhesions, which are mainly caused by various kinds of surgeries and less by previous severe infection or inflammatory reactions.5–7 Sometimes, adhesions-related complications need management, which is often dependent on etiology, location, and the associated symptoms or signs.1 Besides conservative treatment, surgical lysing procedures, called as adhesiolysis sometimes cannot be totally avoided in these subjects with adhesion, since either emergency, such as intestinal obstruction complicated by adhesions or the other indications for further surgery, such as recurrent uterine myomas, adenomyosis, chocolate cysts, or others may occur. Minimally invasive procedures, such as hysteroscopic, laparoscopic, and robotic approaches, are very popular in the management of subjects with various indications for surgeries,5,8,9 and additionally, these approaches are also reported as the preferred options for adhesiolysis.1,10 However, it is believed in long term that history of any of myomectomy, cystectomy, electrofulguration for endometriosis, appendectomy, or bowel surgery is considered as a “contraindication” for laparoscopic surgeries,11 although this hypothesis is worthy of being tested. In the current issue of the Journal of the Chinese Medical Association, we are happy to learn that Dr. Wang and colleagues attempted to clarify  \n*Address Correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); [pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang).  \nConflicts of interest: Dr. Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2022) 85: 813-814.  \nReceived May 21, 2022; accepted May 24, 2022.  \ndoi: 10. 1097/JCMA.0000000000000756.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nthe possibility to use a robotic approach to perform total hysterectomy in patients with intra-abdominal adhesions.12  \nThe authors enrolled 410 women with uterine myoma/adenomyosis undergoing robotic total hytserectomy.12 The authors found that surgical difficulty was really present in the subjects with adhesions because more patients with higher severity need","cbCaibTt2u75MFQQ","https://ap.wps.com/l/cbCaibTt2u75MFQQ","pdf",294768,"English","# Editorial: Pelvic adhesion - A challenge of all gynecologic surgeries\n## Pathophysiology and clinical impact of adhesions\n## Surgical management and the role of minimally invasive techniques\n## Evidence from robotic and laparoscopic approaches","[{\"question\":\"What are pelvic adhesions and how do they develop?\",\"answer\":\"Pelvic adhesions are fibrous tissue connections formed after fibrin deposition during internal healing and inflammatory processes across multiple overlapping phases.\"},{\"question\":\"Why are pelvic and intra-abdominal adhesions particularly common?\",\"answer\":\"They are mainly caused by surgeries, far more often than by severe infection or inflammatory reactions.\"},{\"question\":\"How do minimally invasive approaches relate to adhesions and adhesiolysis?\",\"answer\":\"Surgical adhesiolysis is sometimes necessary, but minimally invasive hysteroscopic, laparoscopic, and robotic options are frequently preferred; evidence suggests adhesions are not necessarily a contraindication for minimally invasive surgery.\"}]","Pelvic adhesion - A challenge of all gynecologic surgeries | PDF",1790679395]