If you've had prior surgeries, it's very likely you have ADHESIONS!! Adhesions result as the human body heals itself following a trauma - and surgery is a trauma to the body!! The formation of adhesions is a completely natural process - the way the body protects itself!!
Adhesions DO cause pain; but MOST surgeons will NOT operate for adhesions, unless the patient is having an emergency bowel obstruction!! Surgeons do NOT like to operate for ADHESION for several reasons:
1.) When the patient has had prior surgery, surgeons know they will have to deal with adhesions. I
2.) If the patient has had several prior surgeries (especially laparotomy procedures), surgeons are fully aware that each surgery will increase the formation of even more adhesions!!
3.) For the surgeon, there's a lot of risk involved with performing adhesiolysis procedures!! When the patient has severe adhesion-involvement, there is the ever-present possibility that he/she might accidentally nick the bowel, sever a blood vessel, cut into the bladder, etc. Surgeons do not like to perform surgeries - where there's the potential for a lot of risk!!
4.) There aren't any adhesion barriers that will offer 100% protection against the formation of adhesions!!!!
SprayGel adhesion barrier IS a very promising adhesion barrier; however, at this time, SprayGel is available ONLY in Europe!! Clinical trials for SprayGel have not yet begun in the United States!! It may take as many as 2 years for SprayGel -- http://www.confluentsurgical.com/ --to complete the required clinical trials - before Confluent Surgical will be ready to seek the approval of the FDA!!!
5.) Surgeons know they will be poorly reimbursed by Medicare and other insurance programs for adhesioysis procedures; because adhesions are not recognized as being a disease yet!! Consequently, adhesion surgeries are one of the lowest paid surgical procedures.
6.) For the surgeon - an adhesiolysis can be a very time-consuming procedure!! There aren't any surgeons, who really want to perform a lengthy surgical procedure for adhesions!!
Imagine you are a surgeon: Would you be willing to spend many hours (3-10 hours)lysing adhesions, when you know you will be paid for only 1 or 2 hours? The maximum reimbursement by Medicare and other insurances is for up to 2 hours!! If the procedure takes as many as 3-10 hours, then the surgeon will have to "write that off"; and he/she will not be able to collect the balance from the patient.
When I had a diagnostic laparoscopy in August 1997, my surgeon had to "write off" almost half of cost of my surgery - he couldn't bill me for the rest. I only had to pay $13.00 - that's all!! Unfortunately for me, I was dropped as his patient!!!
7.) Surgeons know there's only way for them to be paid adequately - for their time and their work; and that is to combine a better paying procedure with an adhesiolysis!!
Unfortunately, sometimes the surgeon will remove an abdominal-pelvic organ - only to find out later that pathologically there was nothing wrong with the severed organ. The organ was healthy - not diseased!! A situation like this is a set-up for a malpractice suit for a surgeon; so this explains why MOST surgeons refuse to perform for adhesions. They would rather be SAFE than SORRY!!
I probably will never know what kind of surgery Bobbie is scheduled to have next Monday; but I hope that I have helped at least one person to avoid an unnecessary surgery -a surgery that involves the possible removal of healthy body parts. The best example of this is a hysterectomy - a hysterectomy that is done for the wrong reasons. Unless diagnostic tests reveal a hysterectomy is necessary, do not elect to have a hysterectomy!!
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At Fri, 26 Apr 2002, Karla N wrote:
I guess I will jump on this one and ask why you are having portions of your intestines removed. Are you obstructed? If not, why are you having the surgery? I know, people don't like hearing me say that they shouldn't have surgery when they are in so much pain, but if you are not obstructed then there is no emergent need for surgery. I can tell that there isn't anyway since they are waiting until Monday to do it. If it was a total obstruction they would be doing the surgery Today! I know, it is easy for me to say don't have the surgery....learn to live with the pain....actually it isn't easy. I don't like telling people what to do....I don't like telling people they should learn to live with their pain...but I must. I don't want people ending up like me. Karla
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