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
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Adhesions can cause:
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:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your doctor will perform a physical exam and may order some of these tests:
Leading up to the surgery:
General anesthesia—blocks pain and keeps you asleep through the surgery; given through an IV in your hand or arm
This surgery is usually done laparoscopically. After you are asleep and not feeling any pain, 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. The doctor will make several small incisions in the wall of the abdomen. Using small instruments that are put through these holes, the doctor will cut out the adhesions. Doing so will free the organs that were caught in the adhesions.
In some cases, the doctor may need to switch to open abdominal surgery (called laparotomy). The doctor will make a larger incision 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:
There are also steps you can take to reduce your chance of infection, such as:
When you return home after the surgery, do the following to help ensure a smooth recovery:
Call your doctor if any of the following occur:
If you think you have an emergency, call for medical help right away.
American College of Surgeons
International Adhesions Society
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.
Katz VL et al. Comprehensive Gynecology. 5th ed. St. Louis, MO: Mosby; 2007.
Khatri VP, Asensio JA. Operative Surgery Manual. 1st ed. Philadelphia, PA: Saunders; 2003.
Kumar V, Abbas AK, et al. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, PA: Elsevier; 2005.
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.
A patient’s guide to adhesions and related pain or…you are not alone. International Adhesions Society website. Available at: http://www.adhesions.org/ptguide_print.htm. Published 1998. Accessed September 16, 2005.
Saravelos HG, Li TC, et al. An analysis of the outcome of microsurgical and laparoscopic adhesiolysis for chronic pelvic pain. Hum Reprod. 1995;10:2895-2901.
Stenchever MA, Droegemueller W, et al., eds. Comprehensive Gynecology. 4th ed. St. Louis, MO: Mosby; 2001.
Townsend CM, et al. Sabiston Textbook of Surgery. 17th ed. Philadelphia, PA: Saunders; 2004.
Last reviewed November 2012 by Marcin Chwistek, 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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