Near Adhesion-Free Reconstructive Pelvic Surgery (NARPS)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

Near Adhesion-Free Reconstructive Pelvic Surgery (NARPS) is a surgical approach developed to systematically minimize the formation of new adhesions during and after complex pelvic surgery.¹ The central premise is that while postoperative adhesion formation cannot be eliminated entirely, it can be reduced substantially through deliberate, technique-level choices at every stage of the operation.

NARPS applies principles of magnification, sharp rather than blunt dissection, continuous peritoneal irrigation, careful hemostasis, and placement of anti-adhesion barriers at closure. Each element targets a known mechanism of adhesion formation: desiccation, ischemia, bleeding, and peritoneal trauma. No single step accounts for the outcome. The reduction comes from applying all of them consistently.

The 2010 outcomes paper documented three distinct phases of refinement over 23 years: Phase I (1987 to 1993, 26 patients), Phase II (1994 to 2005, 44 patients), and Phase III (2006 to 2009, 25 patients).¹

Postoperative adhesion scores declined progressively across the three phases, reflecting measurable improvement with each iteration of the technique. The data establish that a near-adhesion-free result is a documented clinical target, not a marketing claim.

NARPS is closely associated with pelvic excision and repair surgery. Where that entry describes the procedure applied to specific pathology, NARPS describes the set of technical principles governing how that procedure is performed. The two concepts work together: one names what is done, the other names how it is done to protect the tissue afterward.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.