What is Laparoscopic Lysis of Adhesions?

When is laparoscopic lysis of adhesion required?

Adhesions can have a long-term impact on the patient and the organs of the patient’s body. Adhesions are also formed naturally after an infection or inflammation. The following may also lead to the formation of adhesions:

• Endometriosis: Formation of endometrial tissue outside the womb causing scarring in the belly and pelvis
• Diverticulitis: Tear or blockage of diverticula by stool (small pouches that forms on the walls of the large intestine)
• Appendicitis: Inflammation of the appendix
• Crohn disease: Inflammatory bowel disease caused due to long term inflammation of the digestive tract

Laparoscopy is recommended if the patient faces the following:

• Severe pain
• Vomiting
• Bowel obstruction
• Infertility
• Motion limitations
• Blockage of intestines

Laparoscopy can relieve the patient from chronic pain caused by the adhesions, treat intestinal blockages and infertility.

How is laparoscopic lysis of adhesion carried out?

The most common method of lysis of adhesion is laparoscopy, as it is minimally invasive. However, open surgery using large incisions is also an option but possesses more complications and longer recovery time. The laparoscopy surgery follows the procedures as given below:

• The patient is given general anesthesia
• The abdomen is filled with carbon dioxide to expand so the surgeon can work efficiently
• The surgeon makes several small incisions (2-4) on the lower abdomen
• A laparoscopy (a lighted instrument with a camera at the tip) is inserted through one incision. This will provide the surgeon with a live video feed on the screen
• The surgical tools are inserted through the other incisions
• The adhesions are cut and removed, allowing the organs to move freely
• The tools are removed, and the incisions are stitched back.

What are the possible risk factors in the laparoscopic lysis of adhesions?

The risks involved in this procedure are minimal. Some of the possible complications that may occur are as follows:

• Infection
• Bleeding
• Incision
• Damage to intestine
• Damage to organs or joint
• Recurrence of adhesions
• Risks of anesthesia

The surgeon may have to switch to or perform an open surgery in certain cases by making a larger incision to cut out the adhesions. However, open surgery is more complicated for lysis of adhesions than laparoscopy and takes longer for the patient to recover fully.

What can you expect during post-surgical care for laparoscopic lysis of adhesions?

Patients must undergo certain tests recommended by the surgeon or specialist to determine the surgery to be adopted, complications, if any and adhesions. Some of the tests are:

• Blood test
• Urine test
• Ultrasound
• CT scan
• MRI scan

Patients are advised to discuss any medication they are currently consuming, food habits, chronic disease the patient is suffering from before the surgery. In addition, patients must refrain from the following before the surgery to reduce risks at the time of the surgery and post-surgery:

• Smoking
• Consumption of alcohol
• Consumption of any medication that may cause problems to the recovery

Patients are advised not to consume any food or beverage before the surgery.

What are the recovery and post-surgery instructions?

The procedure may take 1-3 hours, and the patient will not experience any pain during the surgery due to anesthesia. Doctors will prescribe medication for any pain or discomfort experienced after the surgery.

Patients can take the following precautions to avoid any infections or complications post-surgery:

• Regular hand wash
• Keep the incisions covered and untouched
• Avoid strenuous physical activities
• Maintain a healthy diet
• Avoid immediate consumption of alcohol

Recovery from laparoscopic lysis of adhesions is rapid, and patients will not have to stay in the hospital for over a day unless recommended otherwise. A full recovery can be achieved after 1-2 weeks of surgery and when the incisions have completely healed.