Adhesions are scars that form within the body. They usually form in the abdomen or pelvis. Adhesions develop naturally after surgery as part of the healing process. They can also develop after infection or any other inflammatory process, such as: EndometriosisDiverticulitisAppendicitisCrohn's disease
Lysis of adhesions is the process of cutting scar tissue within the body. This is done to restore normal function and reduce pain.
Laparoscopic Cutting of Bowel Adhesions
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Adhesions can cause: PainObstruction of the bowelInfertility
This surgery can fix intestinal blockage and treat infertility caused by adhesions. It also reduces chronic abdominal pain in some individuals.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Injury to organsWorse adhesionsBleedingInfectionHernia
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinking
Chronic diseases, such as
Your doctor will perform a physical exam and may order some of these tests: Blood and urine tests
Imaging tests will be used to look for adhesions and complications from them:
UltrasoundCT scanMRI scan
Leading up to the surgery: Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.Arrange for a ride home from the hospital. Also, arrange for someone to help you at home.Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
This surgery is usually done
. When you are asleep, a needle will be inserted to inject a gas into the abdomen. The gas will make the abdomen expand. This will make it easier to see the organs. The laparoscope will then be inserted through a small hole that is cut in the skin. The laparoscope lights, magnifies, and projects an image onto a screen. The area will be inspected. Several small incisions will be made in the wall of the abdomen.
Using small instruments that are put through these holes, the adhesions will be cut out. Doing so will free the organs that were caught in the adhesions.
In some cases, the doctor may need to switch to or do open abdominal surgery (called
). A larger incision will be made in the abdomen. This will allow direct access to all of the organs. The adhesions will be cut out.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
This surgery is done in a hospital setting. If you have laparoscopic surgery, you will be able to leave that day or the next. If you have open surgery, you will need to stay in the hospital for a few days. You may need to stay longer if you have complications.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding your healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
Some activities will be restricted until the wounds are fully healed. Be sure to follow your doctor's instructions.
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision sitePain that you cannot control with the medications you have been givenPersistent nausea and/or vomitingDiarrhea, constipation, bloody stool, or black stoolAbdominal swellingTrouble urinatingCough, shortness of breath, or chest pain
If you think you are having an emergency, call for emergency medical services right away.
Dunker MS, Bemelman WA, et al. Long-term outcomes and quality of life after laparoscopic adhesiolysis for chronic abdominal pain.
J Am Assoc Gynecol Laparosc.
Lamvu G, Tu F, et al. The role of laparoscopy in the diagnosis and treatment of conditions associated with chronic pelvic pain.
Obstet Gynecol Clin N Am.
Szomstein S, Lo Menzo E, et al. Laparoscopic lysis of adhesions. World J Surg. 2006;30(4):535-540.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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