X> LAPAROSCOPIC SURGERY FOR ADHESIOLYSIS...by Harry Reich, M.D., F.A.C.O.G., FACS
"Postoperative adhesions occur after almost every abdominal surgery and are the leading cause of intestinal obstruction. In one study, 93% of patients who had undergone at least one previous abdominal operation had postsurgical adhesions. This was not considered surprising, given the extreme delicacy of the peritoneum and the fact that apposition of two injured surfaces nearly always results in adhesion formation.
"Fatal sequelae of intraabdominal adhesions were reported as early as 1872 after removal of an ovarian tumor resulted in intestinal obstruction. Adhesions are the most common cause of bowel obstruction and most likely result from gynecologic procedures, appendectomies and other intestinal operations. Adhesions have also been proposed to cause infertility and abdominal and pelvic pain. Although nerve fibers have been confirmed in pelvic adhesions, their presence is not increased in those patients with pelvic pain. In addition, there does not appear to be an association between the severity of adhesions and complaint of pain. It is generally accepted that adhesions may impair organ motility resulting in visceral pain transmitted by peritoneal innervation. Many patients experience resolution of their symptoms after adhesiolysis. This may be complicated by placebo effect as demonstrated by one study that showed no difference in pain scores between patients who were randomized to adhesiolysis versus expectant management.
"In 1994, adhesiolyis procedures resulted in 303,836 hospitalizations, 846,415 days of inpatient care, and $1.3 billion in health care expenditures. Forty-seven percent of these hospitalizations were for adhesiolysis of the female reproductive system, the primary site for these procedures. In comparison to similar data from 1988, the cost of adhesiolysis hospitalizations is down. One significant influence on this trend is the increased use of minimally invasive surgical techniques resulting in fewer days of inpatient care."
Please go to the above website to learn as much as you can about adhesions. Dr. Harry Reich is the author of "Laparoscopic Surgery For Adhesiolysis." This is information you may want to share with your physician.