Occurrence of adhesions in the body is relatively more common than it might actually be thought to be. Adhesiolysis is a surgical procedure performed to remove or segregate adhesions in order to regain the normal anatomy and functionality of an organ, as well as the pain induced, can be reduced. Laparoscopic adhesiolysis is one of the medical ways to approach the lysis of adhesions in the body. Before we delve deep into understanding the process of laparoscopic adhesiolysis it is important to collect adequate awareness around the concept of occurrence of adhesions in the human body, the common symptoms and adverse effects from it.
Adhesions can be referred to as a band of scar tissues that are initially developed in the body as a mode of natural repair for any kind of tissue disturbance can occur due to surgeries, infections, radiations or conditions such as endometriosis ( which often leads to the production of more adhesions than average ). It is very rare when adhesions occur without any apparent or known tissue trauma since majorly they occur as a part of the normal healing process.
Typically, adhesions occur near the peritoneal surface although, it can also be formed between two surfaces or between two adjacent organs like the fallopian tubes, intestines, momentum or the abdominal wall. Thus, adhesions can result in the binding of two organs or tissues together in such a way that it leads to pangs of pain or malfunctioning of organs. In some of the rare cases, it can also result in life-threatening conditions such as bowel obstruction. They can broadly occur as either thin, avascular sheets of tissue or thick vascular fibroid bands of adhesion, among which the latter is considered to be a more severe and difficult to remove the condition.
Typically, there aren’t any major and visible symptoms of the presence of adhesions in an individual. However, in some cases, it can cause pain by pulling nerves either within an organ having adhesions or even within the adhesion itself. The symptoms of the presence of adhesions that can lead to your doctor suggesting you to undergo laparoscopic adhesiolysis can fall under the below-mentioned list of major symptoms:-
Although there aren’t any apparent symptoms marking the presence of adhesions any person undergoing any kind of surgical procedure is bound to suffer from adhesions later. However, it can also occur in the people who haven’t had any surgery ever but for the people who have indulged in any kind of surgery are highly likely to have adhesions. Not all kinds of adhesions require treatment to be removed from the body. Some are just harmless while some can be reduced to a level where they don’t cause any discomfort by assuring a healthy or majorly liquid diet and proper lifestyle as well.
Diagnosis of adhesions is, however, a tricky area. Established tests like blood tests, X-ray procedures, CT scans, MRIs and ultrasounds aren’t capable enough to detect an adhesion. Hysterosalpingography (an X-ray that views the inside of the uterus and fallopian tubes) can help to diagnose adhesions but only in case of the uterus and fallopian tubes. Diagnostic laparoscopy is then the only test that facilitates the specialist to be able to diagnose the adhesions and in case of confirmation of the presence of adhesions they can be removed simultaneously and this procedure indeed is known as laparoscopic adhesiolysis. However, asking the patient to undergo laparoscopy is suggested only after all the possible tests to confirm the cause of symptoms that can parallelly hint towards the presence of adhesions is already carried out. In case none of the tests led to any concrete accessible cause to such symptoms the doctor may then suggest a laparoscopy.
Laparoscopy is a process in which a tube with a camera, light and in some cases the medical instrument is inserted into the body through a very short cut. The camera of the tube is synced with the monitor access to the doctor where it can precisely study the internal condition. Laparoscopic adhesiolysis, also known as keyhole surgery, is a process where laparoscopy is used to remove adhesions by either cutting them off by scalpel or else by electric current. Laparoscope provides clear and precise visualization and magnification of the adhesions and the affected organs. The gas (in most of the cases CO2) which is used to inflate the area facilitates the doctor to achieve a natural space between organs to carry out the surgery successfully and with lesser risks.
There are few other ways to treat adhesions as well like medications, exercise, physical therapy, lifestyle changes and open adhesiolysis. On one hand where medications aren’t sufficient enough to treat adhesions and are economically straining as well and rest of the ways may lead to a frequent or quick reoccurrence of adhesions. Thus, laparoscopic adhesiolysis poses to one of the best suitable options. Some of the major advantages of opting laparoscopic adhesiolysis are as follows:-
Thus, in the case of adhesions that are problematic enough to push a patient to surgery, laparoscopic adhesiolysis is highly recommendable but definitely under proper and efficient medical assistance and supervision.
A Laparoscopic procedure is one where your healthcare professional views the inner workings of your stomach by inserting a small camera attached to a tube. This instrument is called as a Laparoscope. Considering the fact that the size of the laparoscope is just 5-15m, the procedure is minimally invasive and has limited risk
Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in ladies who have polycystic ovary disorder (PCOS). Electrocautery or a laser is utilized to annihilate portions of the ovaries Ovarian drilling is in some cases utilized for women with PCOS who are still not after trying weight loss and fertility medicine. Destroying some portion of the ovaries may re-establish regular ovulation cycles. For women who don’t react to treatment with medication, for example, clomiphene, about half of them might probably able to become pregnant after they have ovarian drilling surgery. Ovarian drilling may influence the quantity of eggs you have left or may cause early menopause. Talk with your specialist about these potential dangers. Ovarian drilling may make your menstrual cycles progressively standard, yet after some time they may wind up unpredictable once more.
Laparoscopy ovarian drilling is a surgical treatment that can trigger ovulation in women who have polycystic ovary syndrome (PCOS). Electrocautery is used to destroy parts of the ovaries. Ovarian drilling is usually done through a small incision (laparoscopy), with general anesthesia. The surgeon makes a small cut (incision) in the abdomen at the belly button. The surgeon then places a tube to inflate the abdomen with a small amount of carbon dioxide gas so that he or she can insert the viewing instrument (laparoscopy) without damage to the internal organs. The surgeon looks through the laparoscopy at the internal organs. Surgical instruments may be inserted through the same incision or other small incisions in the pelvic area.
Since its introduction in 1984, laparoscopic ovarian drilling has evolved into a safe and effective surgical treatment for anovulatory, infertile women with polycystic ovary syndrome (PCOS), unresponsive to clomiphene citrate. It is as effective as gonadotropins in terms of pregnancy and live birth rates, but without the risks of ovarian hyperstimulation syndrome and multiple pregnancies. It improves ovarian responsiveness to successive ovulation induction agents. Its favorable reproductive and endocrinal effects are sustained long. Despite its advantages, its use in unselected cases of PCOS or for non-fertility indications is not prudent owing to the potential risks of iatrogenic adhesions and ovarian insufficiency.
Dr. Nidhi Sharma Chauhan – is a practicing Gynaecologist with expertise in Fertility Treatment and Laparoscopic surgery.
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