Lysis of adhesions is a medical procedure addressing internal scar tissue that causes discomfort and dysfunction. This surgical intervention involves the careful division of fibrous bands, known as adhesions, which abnormally connect organs or tissues. This procedure restores natural movement and function of affected structures, often alleviating pain and resolving obstructions.
Understanding Adhesions
Adhesions are bands of fibrous scar tissue that form between internal body surfaces not typically joined. These bands can vary in appearance, ranging from thin, translucent sheets resembling plastic wrap to thick, dense fibrous cords. The formation of adhesions is a natural part of the body’s healing process in response to tissue disturbance.
Abdominal and pelvic surgeries are the most frequent cause of adhesions. Beyond surgery, other common triggers include inflammation from conditions like appendicitis, pelvic inflammatory disease, or endometriosis. Adhesions most commonly develop within the abdomen and pelvis, affecting organs such as the intestines, uterus, fallopian tubes, and ovaries.
Why Adhesions Cause Issues
Many adhesions remain asymptomatic throughout a person’s life. When adhesions cause symptoms, they can significantly impact quality of life by restricting normal organ movement. This restriction can lead to pain, often by pulling on sensitive nerves or tethering organs in unnatural positions.
Bowel obstruction is a concerning complication, where adhesions can kink or twist the intestines. This physical blockage prevents the free passage of food, fluid, and waste, leading to symptoms such as severe abdominal pain, nausea, vomiting, and an inability to pass gas or stool. In women, pelvic adhesions can interfere with reproductive function by obstructing the fallopian tubes or ovaries, potentially leading to infertility. Depending on their location, adhesions can also contribute to other issues, including bladder dysfunction or pain during sexual intercourse.
The Lysis Procedure
The term “lysis” refers to breaking down or releasing; the procedure is also known as adhesiolysis. The most common approach for lysis of adhesions is laparoscopic surgery, a minimally invasive technique. This method involves making several small incisions, typically two to four, in the abdomen.
Through one of these small incisions, a surgeon inserts a laparoscope, a thin tube equipped with a camera and light, allowing a magnified view of the internal organs on a video screen. Additional small surgical instruments are then introduced through the other incisions. To create working space and enhance visibility, carbon dioxide gas is gently inflated into the abdominal cavity. Surgeons identify and cut or burn the adhesive bands to free the organs and restore their natural positioning. In more complex or extensive cases, an open surgical approach with a larger incision may be performed.
Life After Lysis
Following a lysis of adhesions procedure, patients typically experience some abdominal discomfort, fatigue, and possibly nausea or irregular bowel movements. A hospital stay ranging from a few days to a week is common for initial recovery. Patients are generally advised to avoid strenuous physical activity for several weeks, with a gradual return to regular activities usually possible within two to four weeks.
Adhesions can reform after surgery, a recognized challenge in adhesion management. To minimize this risk, surgeons may apply anti-adhesion barriers, such as specialized films or gels, to the surgical site. These bioresorbable barriers, often made from substances like hyaluronic acid or carboxymethylcellulose, act as a temporary physical separator between healing tissues. Laparoscopic surgery generally contributes to a lower rate of new adhesion formation compared to open surgical techniques. While the procedure aims to improve symptoms, the degree of pain relief can vary, and there is a possibility of symptom recurrence.