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What is an adhesiolysis procedure?
Picture of an abdominal scar after adhesiolysis procedure.
Adhesiolysis is a surgical procedure that removes abdominal adhesions.
After abdominal surgery, the scar tissue is formed over the surgical wounds. This is part of the healing process. In some cases, the scars thicken giving rise to bands or lumps of scars known as abdominal adhesions. These adhesions can form between two organs or between an organ and the abdominal wall.
Adhesiolysis can be performed in two ways:
- Open adhesiolysis: A single, large cut (incision) is made through the midline of your body which can be extended to either side of your belly button to remove the abdominal adhesions.
- Laparoscopic adhesiolysis: A tube-like camera is inserted through a single, small incision made into your abdomen to visualize and remove the abdominal adhesions.
What causes abdominal adhesions?
There are 90-95% chances that you may develop abdominal adhesions due to abdominal surgery.
Other causes of abdominal adhesions include:
- Tuberculosis
- Pelvic inflammatory disease (PID): Infections of the reproductive organs of a woman
- Crohn’s disease: Chronic inflammatory bowel disease
- Diverticulitis: Infection of the pouches that may get formed in your intestine
- Peritonitis: Infection of your abdominal cavity (peritoneum)
- Radiation: High-energy waves used in cancer therapy
- Congenital: Present by birth
When do you need open adhesiolysis?
Abdominal adhesions do not usually present with troublesome signs and symptoms. They remain undetected until found accidentally. However, if you experience health issues due to the adhesions, your doctor may recommend you undergo adhesiolysis.
These may be:
- Chronic abdominal pain
- Small bowel obstruction
- Infertility
Open adhesiolysis is generally preferred over laparoscopic procedures when it is difficult to locate the adhesion that is causing the symptoms.
What is done before open adhesiolysis?
- Your surgeon will evaluate your complete physical status and order certain blood tests, X-ray and computerized tomography (CT) scan. He will decide either to give you medical treatment or operate using any of the two adhesiolysis procedures.
- Based on the emergency of your condition, your surgeon will plan adhesiolysis within 48 hours to one week.
- On the day of surgery, you will be given a medicine (general anesthesia) that makes your entire body numb and sleep throughout the procedure.
- A tube known as Foley’s catheter will be inserted into your urethra to know how much urine you are passing and how much fluid is needed by your body to be given through your veins.
- You may also be given an injection of a medication (local anesthesia) on your abdomen to numb the area of operation.
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Pancreatitis is inflammation of an organ in the abdomen called the pancreas.
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How is open adhesiolysis performed?
- A single incision is made through the midline of your abdomen which may extend to either side of your belly button.
- The surgeon identifies the position of the adhesions, cut them, and then connect the necessary abdominal structures.
- In case of a nonfunctioning part of the bowel that has been obstructed by the adhesions, will be cut (resected).
- The surgical wound is examined for any bleeding and wiped with a sterile solution.
- The wound is then closed with surgical threads (sutures) and bandaged.
What is done after open adhesiolysis?
- You will be shifted to the surgical ward and observed for several hours after the surgery.
- Depending upon how well you improve, you will be sent home after three to seven days.
- Your doctor will give you painkillers and antibiotics through your veins till you get discharged from the hospital and advise you to continue them orally for the next three to seven days.
- After the discharge, you will have to monitor your wound to check if it is healing properly.
- Your follow-up with your doctor will be scheduled, generally, after one week.
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What are the complications of open adhesiolysis?
Like any other abdominal surgery, open adhesiolysis too has some complications that include:
- Sepsis (life-threatening response to an infection that can lead to organ failure)
- Acute renal failure
- Respiratory failure
- Myocardial infarction (permanent damage to a part of the heart due to block in the artery that supplies blood to your heart)
- Wound infections
How long does it take to recover from abdominal adhesion surgery?
- You may experience abdominal discomfort for about 14-21 days after abdominal adhesion surgery.
- If there are no complications, you have will have to wait for one or two days after abdominal adhesion surgery to resume your normal activities like walking as followed in any other open abdominal surgery (laparotomy).
- You can resume strenuous physical activities like lifting heavy objects or jogging after four to six weeks of the surgery or as recommended by your doctor.