Cause / Condition
Pelvic and abdominal adhesions may occur as a consequence of infection, endometriosis, appendicitis, or previous surgery. Adhesions may cause acute problems like intestinal obstruction or chronic problems like pain and infertility when the tubes and ovaries are involved. Unfortunately, surgery for adhesions results in reformation of the adhesion in the majority of cases. The use of laparoscopy reduces new adhesion formation and other strategies may improve the outcome further.
About the Procedure
Treating adhesions may be very challenging. Because opening the abdomen by an incision creates even more adhesions, particularly to the newly made incision, the laparoscopic approach is the best solution. Treatment of adhesions in women who have had up to twenty-five abdominal operations, bowel resections for intestinal disease, etc., have been successfully performed by the expert techniques at our institute. The approach may involve using a mini-laparoscope with a 3-mm sheath through several openings in the abdomen until finally it is possible to put in the regular laparoscope through the belly button.
Currently the best method for reducing adhesion permanently forming is to do a second laparoscopy within four weeks of the first, when newly formed adhesions can be bluntly pushed down. Solutions and gels may also be left in the abdominal cavity in an effort to prevent rescarring.
Even though laparoscopic surgery for adhesions may be time-consuming, the recovery is rapid with the ability to go home within a day occurring in over 90% of patients.
Expectations / Experience
Improvement in pain and fertility are the outcomes that are sought after treatment of adhesions. Depending on the original condition and other circumstances laparoscopic surgery has been of marked benefit to these patients.
When small and large bowel is stuck to the pelvic organs and the abdominal wall, freeing it always risks injury with resulting bowel complications. This may occur whether the surgery is done by laparoscopy or by an open incision.
For more information contact:
The Milwaukee Institute of Minimally Invasive Surgery
Columbia St. Mary's Hospital Milwaukee
2301 N. Lake Dr.
Milwaukee, WI 53211