Lysis of Adhesions

Adhesions are internal scars that may lead to troubling side effects. They are bands of scar tissue that can occur anywhere in the body but are usually formed within the abdomen or pelvis. When adhesions are formed, they can cause problems in the normal function of the organs. This scar tissue can cause abnormal "sticking" together of two surfaces. This kind of scar can also "squeeze" an organ and cause a blockage. Adhesions can develop after surgery and may also form as a result of an inflammation or infection. Depending on where the adhesions are, they may cause:

  • Pain.

  • Obstruction of the bowel.

  • Infertility.

  • Other complications.

Lysis (loosening or setting free) is a surgical procedure done to remove or loosen the scars that cause the problems described above. This can help to reduce or relieve pain and help to restore normal function.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies.

  • Medicines taken including herbs, eye drops, prescription medications, over-the-counter medications, and creams.

  • Use of steroids (by mouth or creams).

  • Use of aspirin or blood-thinning medicines.

  • History of bleeding or blood problems.

  • Previous problems with anesthetics or Novocaine.

  • Possibility of pregnancy, if this applies.

  • History of blood clots (thrombophlebitis).

  • Previous surgery.

  • Previous/existing problems with the heart or lung.

  • Other health problems, such as diabetes.

RISKS AND COMPLICATIONS

  • Injury to the bowel, bladder, blood vessels, and/or tubes that carry urine to the urinary bladder (ureters).

  • Bleeding.

  • Infection.

  • Recurrence of adhesions.

  • Abnormal protrusion of an organ through an operative incision (incisional hernia).

BEFORE THE PROCEDURE

Your caregiver may:

  • Discuss the risks and complications of the procedure.

  • Recommend imaging studies and blood tests.

  • Advise you regarding medicines you are taking.

  • Discuss your anesthesia requirements.

PROCEDURE

Lysis of adhesions is usually performed by keyhole surgery (laparoscopically). During this procedure, the surgeon will make a few tiny keyhole incisions. He/she will pass a tiny fiberoptic scope through one hole to view the adhesions on a monitor. Using small instruments that are passed through the other holes, the surgery will be performed to remove the adhesions and free the tissues/organs. The instruments are then removed, and the incisions are closed. This procedure may cause minimal scarring. Sometimes, open surgery (laparotomy) may be required where a single larger incision will be made to allow the surgeon a direct access to the area of the adhesions.

You may be given regional or general anesthesia. If the surgery is going to be performed under general anesthesia:

  • A light meal, such as soup or salad, is recommended on the previous night.

  • You will probably be asked not to eat or drink anything after midnight on the night before the procedure.

AFTER THE PROCEDURE

The surgery may last for 1-3 hours. Depending on the type of surgery, you may have to spend a night or a few days in the hospital. Typically, patients stay in the hospital and can not eat or drink until bowel function returns. Patients may have a tube put in place to decrease problems with the bowels (nasogastric tube). When your system can tolerate food, you can go home. Your caregiver will give you certain medications to control your pain.

HOME CARE INSTRUCTIONS

  • Follow all the instructions given by your surgeon at the time of discharge.

  • Take all prescribed medications as instructed and go for regular follow-ups.

  • Keep the dressing clean and dry.

  • As pain gets less, increase moving and walking and other regular activities that you do every day.

  • Avoid lifting heavy objects unless advised otherwise by your caregiver.

  • At first, you may need to eat only a little at a time. As your appetite improves, you can slowly go back to eating normally.

  • If applicable, your caregiver can help you to know when it is okay to start driving and exercising again.

SEEK MEDICAL CARE IF:

  • You develop fever above 100° F (37.8° C).

  • You develop infection.

  • Your pain increases.

  • You notice redness or swelling at the site of the incision.

  • You have nausea and vomiting that does not go away after a few hours.

  • You have a cough.

  • You have bleeding or oozing from the incision site.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop fever of 102° F (38.9° C) or above.

  • You develop severe abdominal, chest pain.

  • You develop shortness of breath.

  • You experience nausea and/or vomiting that keeps coming back or is severe.