Adhesion Management
What are adhesions?
Adhesions are scar tissue that form between organs as part of the healing process following surgery, infection or an inflammatory process. They are mostly seen in the abdomen and pelvic region and can cause discomfort, obstruction of the bowel and chronic pain. Adhesions can be treated by removing the scar tissues by a surgical procedure called adhesiolysis. This is also referred to as division of adhesions.
How are adhesions diagnosed?
Adhesions are usually detected during surgery performed to treat other conditions. Imaging studies are not effective in determining an adhesion, but can be used to diagnose internal obstructions.
What are the consequences of not treating an adhesion?
If not treated, adhesions can lead to intestinal obstruction, and in women, repeated miscarriage, ectopic pregnancy and infertility.
What are the alternate options to treat adhesions?
Treatment depends on location, extent of harm caused and severity of the adhesion. It is usually symptomatic unless your doctor finds the need for a surgical emergency.
Am I a candidate for adhesiolysis?
Adhesiolysis is indicated for the following:
- Chronic pelvic pain for over 6 months
- Partial or complete small-bowel obstruction that cannot be treated with nonoperative methods
- Recurrence of small-bowel obstruction
- Strangulated or dead bowel
You may not be a candidate for adhesiolysis in the following cases:
- Acute perforation and peritonitis (inflammation of the tissue lining the abdominal cavity)
- Extensive distention of the abdomen that does not allow sufficient working space for the surgery
- Haemodynamic instability
How do I prepare for an adhesiolysis?
Like all surgical procedures preparation is discussed at your consultation but usually involves fasting for a minimum of 6 hours prior to surgery
How is adhesiolysis performed?
Adhesiolysis is performed under general anaesthesia. The surgery is usually performed through the laparoscopic technique, where small incisions are made. Your doctor injects a gas to expand the abdomen so that the organs are clearly visible. Then the laparoscope (a small tube attached with a camera and light at one end) is inserted through an incision to locate the adhesion. The images captured by the camera are displayed on a large monitor, providing your surgeon with a clear enlarged view of the operating site. With the help of surgical instruments inserted through the other incisions, the adhesions are cut or released to free the organs that were joined.
Describe the stages of recovery and care plan.
You will be able to go home within a day of the surgery and can resume your normal activities in 1-2 weeks.
What are the potential complications of adhesiolysis?
Like all surgeries, the laparoscopic management of adhesions may be associated with complications such as injury to the surrounding organs, infection or bleeding, and formation of fresh adhesions.
