Lysis of Adhesions
(Cutting Adhesions; Adhesiolysis)
Definition
Adhesions are scars that form within the body. They usually form in the abdomen or pelvis. They can also form in joints or eyes. 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.
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Reasons for Procedure
Adhesions can cause:
- Pain
- Bowel obstruction
- Infertility
- Range of motion limitations
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 or joint
- 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 one 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.
Abdominal Adhesions
- Small holes will be made in the abdomen to access the affected organs. Gas is used to expand the abdomen to make it easier for the surgeon to see. The laparoscope will then be inserted through the small holes. Tubes with a light and camera project images onto a screen. Once found, the adhesions are cut out by small surgical instruments that are inserted through the tubes. 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. 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.
Joint Adhesions
- When you are asleep, the laparoscope will then be inserted through a small hole that is cut in the skin. The area will be inspected. Several small incisions will be made around the joint. Using small instruments that are put through these holes, the adhesions will be cut out. Doing so will free the adhesions that are restricting joint function.
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 incisions are fully healed. Be sure to follow your doctor's instructions on caring for the incision to prevent infection.
Call Your Doctor
Call your doctor if any of these occur:
- 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 were given
- Persistent nausea or vomiting
- Diarrhea, constipation, bloody stool, or black stool
- Abdominal swelling
- Increasing joint pain or 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
https://www.facs.org
International Adhesions Society
http://www.adhesions.org
REFERENCES:
Adhesion. Mount Sinai website. Available at: http://www.mountsinai.org/health-library/diseases-conditions/adhesion. Updated Apri 5, 2016. Accessed January 10, 2018.
Dunker MS, Bemelman WA, Vijn, et al. Long-term outcomes and quality of life after laparoscopic adhesiolysis for chronic abdominal pain. J Am Assoc Gynecol Laparosc. 2004;11(1):36-41.
Intestinal obstruction repair. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/Fi-La/Intestinal-Obstruction-Repair.html. Accessed January 10, 2018.
Lamvu G, Tu F, As-Sanie S, Zolnoun D, Steege JF. The role of laparoscopy in the diagnosis and treatment of conditions associated with chronic pelvic pain. Obstet Gynecol Clin N Am. 2004;31(3):619-630.
Szomstein S, Lo Menzo E, Simpfendorfer C, Zundel N, Rosenthal RJ. Laparoscopic lysis of adhesions. World J Surg. 2006;30(4):535-540.
Last reviewed November 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 12/20/2014