laparoscopic adhesiolysis infertility

What does Adhesiolysis mean?

What causes adhesions?

Can adhesions be removed laparoscopically?

during abdominal adhesion surgery

How long is recovery from adhesion surgery?

What are the complications of abdominal adhesions?

adhesion

An adhesion is a band of scar tissue that binds two parts of your tissue that are not normally joined together. Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands. The adhesion develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation, resulting in inflammation. Although adhesions can occur anywhere, the most common locations are within the abdominal cavity, the pelvis, and the heart. Adhesions can cause female reproductive problems by obstructing the ovaries or fallopian tubes.

They can also cause painful intercourse for some people. If your doctor suspects adhesions are causing your reproductive issues, they may recommend surgery to remove them.

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laparoscopic adhesiolysis 

What does Adhesiolysis mean?

Adhesiolysis is the first step of adhesion surgery, the process of separating structures that have been fused by adhesions. To carefully remove all adhesions and scarring without causing damage to the other structures, advanced laparoscopic surgical skills and extensive knowledge of anatomy are required.Once all adhesions have been carefully separated, the patient will typically be left with multiple areas of the raw tissue. If these areas are left as they are, adjacent structures may stick to these raw areas resulting in new adhesions. This process typically occurs during the first hours and days following surgery and these newly formed adhesions may then go on to thicken and tighten during the following months. Some people have a greater tendency to form scar tissue and adhesions than others.

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What causes adhesions?

Adhesions develop as the body attempts to repair itself. This normal response can occur after surgery, infection, trauma, or radiation. Repaired cells within the body cannot tell the difference between one organ and another. If an organ undergoes repair and comes into contact with another part of itself or another organ, scar tissue may form an adhesion connecting the two surfaces.

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Can adhesions be removed laparoscopically?

The process of removing adhesions through a laparoscope is called laparoscopic adhesiolysis. Doctors typically diagnose adhesions during a surgical procedure with laparoscopy. 

• If they find adhesions, doctors usually release them during the same surgery using tools threaded through the laparoscopic tube and guided by video images from the scope’s lighted camera. 
• This procedure is usually done under general anesthesia. 
• The surgeon makes a small incision in the area of adhesion and uses a laparoscope to locate the adhesion. 
• The laparoscope will project images onto a screen, and the surgeon cuts out the adhesions. 
• The wounds are sutured with skin absorbable stitches. 
• Laparoscopic adhesiolysis usually takes less than three hours. 

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During abdominal adhesion surgery

Adhesion surgery is usually performed under general anaesthetic. It is usually done as “keyhole surgery”. Your surgeon will make several small incisions (cuts) in your abdomen. They will insert special surgical tools and a thin tube with a camera and light source to examine and remove the adhesions. In some cases they may leave medication in your abdomen to help prevent further adhesions. Your wounds will be closed using stitches or staples.

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How long is recovery from adhesion surgery?

You may have discomfort around your abdomen for about 2 weeks. You should be able to return to regular activities in 2 to 4 weeks. It may also take several weeks for your bowel movements to become regular again.

To improve your recovery from abdominal adhesiolysis surgery, you can:

Get plenty of rest.

Avoid intense physical activity.

Talk to your doctor about foods you should avoid.

Wash the surgical wound daily with soapy water.

Call your doctor or surgeon immediately if you have signs of an infection, such as fever or redness and swelling at the incision site.

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What are the complications of abdominal adhesions?

Abdominal adhesions can cause intestinal obstruction and female infertility.

Intestinal obstruction

Intestinal obstruction is the partial or complete blockage of the movement of food, fluids, air, or stool through the intestines. Abdominal adhesions are the most common cause of obstruction of the small intestine. Intestinal obstruction may lead to

• lack of blood flow to the blocked part of the intestine and death of the blood-starved intestinal tissues.
• peritonitis, an infection of the lining of the abdominal cavity.

Intestinal obstruction can be life-threatening. People with symptoms of a complete blockage which include abdominal pain and passing no fluids, stool, or gas should seek medical attention right away.

Female infertility

In women, abdominal adhesions in the pelvis or inside the uterus can compress or block parts of the reproductive system and cause infertility.

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