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Lysis of Adhesions

(Cutting Adhesions; Adhesiolysis)
  • Definition

    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:
    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
    Abdominal Adhesion
    Copyright © Nucleus Medical Media, Inc.
  • Reasons for Procedure

    Adhesions can cause:
    This surgery can fix intestinal blockage and treat infertility caused by adhesions. It also reduces chronic abdominal pain in some individuals.
  • Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Injury to organs
    • Worse adhesions
    • Bleeding
    • Infection
    • Hernia
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
  • What to Expect

    Prior to Procedure
    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:
    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.
    Anesthesia
    General anesthesia—blocks pain and keeps you asleep through the surgery
    Description of the Procedure
    This surgery is usually done laparoscopically. 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 laparotomy). 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.
    How Long Will It Take?
    1-3 hours
    How Much Will It Hurt?
    Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
    Average Hospital Stay
    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.
    Post-procedure Care
    Preventing Infection
    During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping 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 same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incision
    At Home
    Some activities will be restricted until the wounds are fully healed. Be sure to follow your doctor's instructions.
  • Call Your Doctor

    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 chills
    • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
    • Pain that you cannot control with the medications you have been given
    • Persistent nausea and/or vomiting
    • Diarrhea, constipation, bloody stool, or black stool
    • Abdominal swelling
    • Trouble urinating
    • Cough, shortness of breath, or chest pain
    If you think you are having an emergency, call for emergency medical services right away.
  • RESOURCES

    American College of Surgeons http://www.facs.org

    International Adhesions Society http://www.adhesions.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Healthy U http://www.healthyalberta.com

    References

    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. 2004;11:36-41.

    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. 2004;31:619-630.

    Szomstein S, Lo Menzo E, et al. Laparoscopic lysis of adhesions. World J Surg. 2006;30(4):535-540.

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