ADHESIVE PROCESS AFTER LAPAROSCOPIC MYOMECTOMY: RISK FACTORS, COMPREHENSIVE APPROACH TO MINIMIZATION

Uterine fibroids are a common pathological process affecting 30 to 80% of women of reproductive age. Uterine fibroids are often asymptomatic, but the appearance of complaints of menorrhagia, pelvic pain, symptoms of pelvic organ compression require surgical treatment. In women who want to preserve their fertility, myomectomy is an alternative to hysterectomy. Myomectomy, like any surgical intervention on the pelvic organs, can lead to the formation of an adhesion process, reaching up to 83-94% of cases during laparotomy interventions. Minimizing surgical trauma to the anterior abdominal wall during laparoscopic surgery facilitates early pa-tient mobilization. This reduces the time of postoperative rehabilitation and decreases the severity of the adhe-sion process in the surgical intervention area compared to open surgeries, which helps to reduce the incidence of postoperative complications. However, there is evidence that the frequency of rehospitalization after laparotomy and laparoscopic surgeries on the pelvic organs is comparable. To date, no definitive strategies, recommendations, or guidelines have been developed to prevent the development of pelvic adhesions after myomectomy.