Prediction of intra-abdominal adhesions using the visceral slide test: A prospective observational study

Abstract

ObjectiveThe goal of this study was to determine whether the visceral slide test is an effective screening method for the prediction of intra-abdominal adhesions. Study designA prospective, observational study was conducted assessing a cohort of women undergoing benign gynaecologic surgery between April 2015 and June 2015. At the patient’s preoperative visit, they underwent the ultrasound-based visceral slide test in five zones of the abdomen. The ultrasound assessments were validated against direct visualization during surgery. The effectiveness of the slide test as a screening technique was examined by recording the presence, extent, and severity of adhesions observed intraoperatively; this was scored using a modified version of the American Fertility Society (mAFS) system. ResultsIn total, 144 women completed the study, 33 (22.9%) of whom had previously undergone intra-abdominal surgery. The median time to perform the visceral slide test was 2min, and using our methodology, 48 patients (33.3%) were diagnosed with adhesions. We found that the visceral slide test had a sensitivity of 97.2%, specificity of 68.6%, positive predictive value of 90.6%, negative predictive value of 88.9%, and diagnostic accuracy of 90.3%. Further, the number of negative visceral slide tests was positively correlated with the mAFS scores. ConclusionOur data suggest that the visceral slide test is a simple, fast, reliable assay for detecting intra-abdominal adhesions in patients undergoing gynaecologic surgery.