Adhesions
What are Adhesions
Adhesions are abnormally formed bands of tissue occurring between organs inside the abdomen.
What causes them?
The abdominal organs (bowel, ovaries, tubes etc) are covered with a smooth tissue layer that allows them to slide on one another without sticking. Any abnormal interruption to that layer can cause the tissue to heal inappropriately forming tissue bands or adhesions. Examples of possible causes include: burst appendix, endometriosis, pelvic inflammatory disease or simply previous open surgery (laparotomy).
What are the effects of adhesions?
Adhesions become particularly dangerous and painful when they block or interrupt normal bodily functions. Adhesions can be a cause of a disruption to the passage of stool, which results in severe abdominal pain. Similarly, adhesions may block the ends of the fallopian tubes causing infertility or stop the movement of the uterus or ovaries in the pelvis causing pain during intercourse and fertility issues.
What are adhesions
Adhesions become particularly dangerous and painful when they block or interrupt normal bodily functions. Adhesions can be a cause of a disruption to the passage of stool, which results in severe abdominal pain. Similarly, adhesions may block the ends of the fallopian tubes causing infertility or stop the movement of the uterus or ovaries in the pelvis causing pain during intercourse and fertility issues.
Adhesions are known to form after 60% to 100% of open surgery cases but only 6% to 10% of laparoscopic procedures. Thus, laparoscopy itself reduces the rate of adhesions as less tissue is directly handled, bleeding is controlled under magnified vision and dissection can be magnified many times over to enhance the precision of the surgery.
How does keyhole surgery help?
Keyhole or laparoscopic surgery has a number of other benefits compared to open surgery: Faster recovery, less pain and less scarring.
Can anything be done?
As mentioned, the best way to avoid adhesions is to stop them happening in the first instance by having a keyhole rather than an open procedure. Once formed, adhesions can be removed allowing structures to move more freely, and various adhesion barriers can be placed to stop them reforming. However, there is a disappointing high rate of recurrence.
What do I do now?
Every woman is individual and her situation requires an individual plan of management. If you think these issues relate to you,
call A/Prof. Reyftmann to arrange a personal consultation and discussion of your case.
