Bowel adhesions from previous abdominal surgery What are adhesions?
Adhesions occur as a part of the bodies healing process. When the body is injured either surgically, by infection or otherwise mechanisms are activated to promote healing. Sometimes this is not perfect and results in scar tissue, which is responsible for adhesions. On occasion when two different structures are near or touching each other, and both are involved in the healing process they become stuck together either completely or become joined together by filmy strands that were involved in the healing process.
Adhesions can result from any surgery; some operations produce more adhesions than others particularly those that result in a lot of bleeding during the procedure.
Why are adhesions important?
For most people adhesions will produce no symptoms however, adhesions can be responsible for
What can be done to reduce adhesions?
Being fit and as healthy as possible before an operation will reduce the risk of adhesions.
Surgeons can also play a part in adhesion reduction by
What can be done about adhesions?
For most people with no symptoms no intervention is required. The only reason for intervention would be
In some patients the symptoms can be more severe. This is because sometimes the process that was involved in the production of adhesions works twice as hard to prevent adhesions the second time resulting in denser and thicker scar tissue.
For this reason there are advantage of managing symptoms of pain with conservative measures rather than surgery
Laparoscopic surgery and adhesions
1. Laparoscopic surgery can reduce the risk of adhesion formation. This is because tissues are touched less often and tissues tend to be “washed” periodically during surgery
Laparoscopic surgery in patients with adhesions
1. Advantages
2. Disadvantages
Adhesions occur as a part of the bodies healing process. When the body is injured either surgically, by infection or otherwise mechanisms are activated to promote healing. Sometimes this is not perfect and results in scar tissue, which is responsible for adhesions. On occasion when two different structures are near or touching each other, and both are involved in the healing process they become stuck together either completely or become joined together by filmy strands that were involved in the healing process.
Adhesions can result from any surgery; some operations produce more adhesions than others particularly those that result in a lot of bleeding during the procedure.
Why are adhesions important?
For most people adhesions will produce no symptoms however, adhesions can be responsible for
- Pain
- Intestinal (bowel) obstruction
- Infertility if they involve the pelvis particularly the fallopian tubes in women
What can be done to reduce adhesions?
Being fit and as healthy as possible before an operation will reduce the risk of adhesions.
Surgeons can also play a part in adhesion reduction by
- Using good surgical technique
- Reducing the exposure of tissue to the atmosphere (intermittent perfusion of tissue or covering the tissue with moist swabs)
- Reduction in the amount of bleeding
- Reducing the risk of infection
- The use of laparoscopic surgery for some procedures reduces the risk of adhesions by half.
- The use of anti-adhesive agents at the time of surgery
What can be done about adhesions?
For most people with no symptoms no intervention is required. The only reason for intervention would be
- Symptoms of intestinal obstruction
- Improvement of fertility in selected patients
- Reduction of pain symptoms
In some patients the symptoms can be more severe. This is because sometimes the process that was involved in the production of adhesions works twice as hard to prevent adhesions the second time resulting in denser and thicker scar tissue.
For this reason there are advantage of managing symptoms of pain with conservative measures rather than surgery
Laparoscopic surgery and adhesions
1. Laparoscopic surgery can reduce the risk of adhesion formation. This is because tissues are touched less often and tissues tend to be “washed” periodically during surgery
Laparoscopic surgery in patients with adhesions
1. Advantages
- Laparoscopic surgery can have advantages in patients who have had previous surgery and are thought to have adhesions
- Better visualization of tissues and structures
2. Disadvantages
- Laparoscopic surgery can potentially be dangerous in women who have adhesions as there can be an increase in the risk of bowel injury in such patients
- Surgeons usually insert the surgical ports away from the site of surgery to prevent bowel damage.
- If the adhesions are too dense then open surgery may be necessary
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