Adhesions

Adhesions

An adhesion is excess scar tissue that has developed within the body. Most commonly in the area of the abdomen or pelvis. Lysis is the process of cutting away the adhesion. When there is an adhesion, two organs may form an abnormal attachment which can affect the functioning of one or both organs involved and may also cause pain. Surgery to repair adhesions was formerly a rare procedure, but with the development of minimally invasive laparoscopic techniques, the lysis of adhesions has become more common.

Causes of Adhesions

Adhesions may develop for a variety of reasons. Most frequently, they are the result of surgery or inflammation. Specific causes may include the following:

  • Endometriosis
  • Diverticulitis
  • Appendicitis
  • Radiation treatment for cancer
  • Gynecological infections

Symptoms of Adhesions

The most common symptom of adhesions is chronic pain at the site. Symptoms may vary depending on the location of the adhesion, for example, a vaginal adhesion may cause pain during sexual intercourse and pericardial adhesion may result in chest pain. Intestinal adhesion may cause one or more of the following symptoms:

  • Bloating
  • Constipation
  • Severe abdominal pain
  • Loud bowel sounds
  • Inability to pass gas
  • Vomiting

In more severe cases, adhesion may cause bowel obstruction or infertility.

Diagnosis of Adhesions

Most adhesions are discovered during exploratory surgery since diagnostic imaging tests, such as X-rays or ultrasound are unable to detect them. If, however an adhesion has resulted in an intestinal blockage, the blockage may be visualized in abdominal X-rays, CT scans and lower GI studies also called barium contrast studies.

Treatment of Adhesions

The lysis of adhesions is an operative procedure involved in  separating the connected organs. This surgery is usually done laparoscopically through small incisions, using small instruments. This minimally invasive procedure is performed to reduce the patient’s symptoms and to free the involved organs so that they can return to their normal function. Any further adhesion surgery increases the chance of an adhesion recurring. Depending on the location in the body that the procedure is taking place, it may be possible for the surgeon to place a barrier at the site to reduce the chance of reoccurrence.

Complications of Lysis of Adhesions

While complications from this procedure are rare, there are always risks involved with any surgical procedure. As noted, the primary risks of surgery is the recurrence of an adhesion. Risks of any surgical procedure may include:

  • Excessive bleeding
  • Blood clots
  • Adverse reactions to anesthesia or medications
  • Post-surgical infection
  • Damage to adjacent organs
  • Breathing problems
  • Hernia at the incision site

Recovery from Lysis of Adhesions

Recovery from the lysis of adhesions is usually uneventful, particularly if the procedure has been done laparoscopically. The laparoscopic surgery is generally performed as an outpatient procedure and the patient should be mostly recovered after a few days. Pain medicine will be prescribed by the physician in the immediate aftermath of the surgery and the incision should be kept clean and dry. Patients are usually advised to refrain from drinking carbonated beverages for a few days and to avoid heavy lifting for several weeks.