Laproscopic Adhesiolysis

Laparoscopy is an effective method for the evaluation of patients with chronic pain. Laparoscopic adhesiolysis is connected with major relief for chronic abdominal pain in more than 80% of patients. Laparoscopic adhesiolysis was also found to be more effective than microsurgical adhesiolysis for infertility.

When tissue that is normally not connected grows together, it is called an adhesion. It is also commonly called as scar tissue. Adhesions are fibrous tissues (scar tissue) that cause organs within the body to stick to other internal organs that are not normally connected. Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands.

The only way to treat adhesions is to remove or separate them through surgery. This procedure is called adhesiolysis.

Studies have stated that laparoscopy leads to less adhesion formation compared to open surgery. The less adhesion formation after laparoscopic surgery is because retraction is not used much, packing of the abdominal cavity is not required that can damage peritoneum. The foreign bodies like glove talk and lint. Also, the excellent visualization and magnification result into less tissue injury and adhesion. In laparoscopy, port wound and wound at the target of dissection is far away from each other so the chances of adhesion are less to the peritoneum because, for adhesion both the layer which tends to adhered should be in contact. In laparoscopic surgery there is less chance of drying of tissue because inside environment is cut off from outside .At least three ports should be used to perform laparoscopic adhesiolysis. After access and introduction of telescope two other ports should be introduced according to baseball diamond concept keeping in mind the centre of adhesion as target of dissection.

The main symptoms of adhesions are pain, cramps, intermittent vomiting, difficulty with passing gas or having a bowel movement and swelling of the abdomen, besides symptoms may vary depending upon the tissue involved.

Adhesions are almost predictable after a surgical procedure. It is up to the surgeon to minimize the risk of adhesion formation. Dr.K.N.Srikanth is aware of this problem and conducts specific adhesion prevention techniques to avoid the formation of new adhesions while trying to eradicate the already existing adhesive disease.

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