Re: Adhesions & post- Laparoscopic complications
From: Karla Nygren (ifirgit@up.net)
Mon Apr 24 10:22:27 2000
RE: Adhesions & post- Laparoscopic complicationsLaura,
I think many of us have been told that we should never, ever have surgery again......me being one of them. Unfortunately, not all of us that option. The physician that I believe you are going to see is very skilled in laprascopy....and if he felt he could not handle your case he would not do it. He certainly would back out if he felt that he could not handle it....but, those are questions that you can ask him when you have your consultation. If it were me, I would address these issues with the doctors that are to be involved in your case and speak with some of their patients. I think individuals on this list can provide you with the names of people that have gone through the procedure....some of them very severe.
God Bless You,
Karla N.
> ----- Original Message -----
From: LNewman@milbank.com
To: Multiple recipients of list ADHESIONS
Sent: Monday, April 24, 2000 9:18 AM
Subject: RE: Adhesions & post- Laparoscopic complications
Are you saying that the more extensive the adhesions, the worst chance for the patient's survival or injury? I need to know that because I am planning to see a "professional" that is the pioneer of a procedure that will almost surely end the suffering of our people. I have been told on numerous occasions, after surgery, that I should NEVER have surgery again, unless it is life-threatening because my abdomen is like cement and very sticky. I need to have a response from you soon regarding this because I am planning to call and schedule a consultation.
-----Original Message-----
From: anonymous@obgyn.net [SMTP:anonymous@obgyn.net]
Sent: Sunday, April 23, 2000 7:12 PM
To: Multiple recipients of list ADHESIONS
Subject: Adhesions & post- Laparoscopic complications
Hi,
I just wanted to put out a word of general caution. There are times
that lap surgery of any type is appropriate for adhesion lysis. There
are certain individuals that due to the severity of their adhesions
should not be subjected to laparoscopic surgery...especially if that
laprascopist's experience is limited to a typical gyn practice. There
are lap docs who confine their surgery to scope surgery only. I am NOT
saying that a gyn could not do the surgery. What I am trying to get
across is there are cases of severe adhesions that first of all surgery
will not help...that will actually produce more adhesions. The hard
evidence I've seen states that: Laparoscopic surgery is associated with
a lower incidence of wound adhesion. It is not associated with a lower
incidence of actual internal abdominal adhesions. If you have severe
dense adhesions you really need to weight the potential risks. There
are serious complications associated with this type of surgery. Most
physicians and patients have an attitude that after the surgery is over
and they are 7 or more days post-op, "hey, no problem". They don't
relate symptoms that crop up to the surgery. This can be really bad
news. People have not survived due to this attitude. If you are even
14 days post op and you begin feeling a bit ill, have a fever, nausea,
vague abdominal pain, dehydration, or other symptoms you need to rule
out the possibility of post op complication. This means it must be
diagnosed and ruled not to be associated with surgery. There is a
gentleman who almost died one year after an apendectomy...the area
walled off and formed an abcess which later burst. Complications can
include perforated bowel or other organs, infection, bleeding, etc. You
may have symptoms of a "PID" and the doc will say it was because you are
not clean or due to sex...etc. That it was caused by bacteria entering
the vagina and traveling up as far as the tubes...reality is that it can
be caused from the inside out...it can be caused by surgical
contamination. Many times the scope will keep fogging up...I know of
someone who became ill after a microscopic piece of fiber somehow became
inbedded (?) in the bowel wall and became infected. There are really
more cases out there than previously believed. The real "Experts" know
about these cases. They know how many scope surgeries have been
converted to open procedures...
I just feel that a woman or man, as it affects them too, should be fully
aprised of their particular case and the benefits vs risks of a
particular type of surgery along with a realistic discussion of the
potential complications.
A for instance. The risk of perforated bowel, infection, or bleeding
from a scope surgery is fairly low. They happen but the risk is fairly
low...generally speaking. If you have severe, dense, adhesions that
obliterate (make it so the surgeon cannot identify planes)then you do
not fall in that generally speaking category. Of course this can be
dependant upon where the adhesions are located, which ones the surgeons
attempt to lyse, what type of instruments, cautery devices, or lasers
they choose to use, and laparoscopic skill...Calling oneself an expert
is oftentimes subjective. The surgeon may have only two years
experience, he does 10 tubal ligations with a scope on virgin abdomens
per week, and a few other scope surgeries...this does not an expert
make...there are actual levels of competancy...Level one, level two,
etc. Your idea of an expert may be 8 years or more experience and his
may be one or two courses and a couple scope surgeries per week. I am
NOT out to bash doctors...I have doctors too...I am out to hopefully
educate women...I have huge amounts of info...and "inside" info that
women and men must be aware of before undergoing lap surgery. I've
heard all the pros and cons and then some...
Anyway, if you have a complicated belly then the risk goes up for you
and is directly related to how complicated your belly is. The
complications are life and death situations that generally are not
caught at the time of surgery. If you are two weeks post-op you and the
surgeon may not be looking at the possibility of surgical complications
thus placing you in jepardy. Also remember that you may or may not have
temporary relief...For me personally, unless I had a bowel obstruction,
stricture, etc. then I cannot subject myself to any more. There are
advantages to open procedures too. It's just hard to judge.
I feel it is ever so important that post-scope patients be given at
discharge a list of potential symptoms of post-op complications...not
just the standard or typical post-op instructions but ones that are
specifically written for that specialized type of surgery. It would
also be helpful if your doctor discussed with you precisely what he did
in there...did he have a tough time with anything in particular, was the
surgery difficult or easy? Did he at any time think he should back out?
I've heard the positive outcomes but I also know of the potential
complications...
Just be careful...really check it out...I don't want any of you sustaing
serious damages.
http://www.adhesions.org/forums/listcmds.htm
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