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Postoperative Adhesion Surgery (Adhesiolysis)

Surgical division of fibrous bands forming after prior abdominal surgery causing pain or bowel obstruction.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Postoperative Adhesion Surgery (Adhesiolysis)?

Intra-abdominal adhesions are fibrous bands that form between intra-abdominal organs and the peritoneal wall after surgery, infection or inflammation. They develop in up to 90% of patients after open abdominal surgery and account for 60-70% of small bowel obstructions, chronic abdominal pain and secondary infertility cases requiring surgery.

Pathogenesis involves peritoneal injury triggering fibrin deposition, fibroblast proliferation and collagen synthesis when normal fibrinolysis is overwhelmed. Risk factors include peritonitis, pelvic surgery, endometriosis, foreign material exposure, ischemia and individual genetic predisposition. Clinical presentations range from asymptomatic adhesions to recurrent partial obstruction, complete obstruction, chronic pelvic pain or infertility.

Adhesiolysis (open or laparoscopic) carefully separates organs and divides bands using sharp dissection, harmonic or bipolar energy. Adhesion-prevention adjuvants (hyaluronate-carboxymethylcellulose film, oxidized cellulose, icodextrin solution) reduce recurrence. Risks include enterotomy, vascular injury and recurrence, with reformation rates of 30-50% even with optimal technique.

Symptoms

Chronic abdominal pain
Recurrent bowel obstruction episodes
Bloating and altered bowel habits
Postprandial pain
Infertility (in women)
Pelvic pain with intercourse
Nausea and vomiting
Distension
Constipation alternating with diarrhea
Weight loss with chronic obstruction

Risk Factors

Prior open abdominal surgery
Pelvic inflammatory disease
Endometriosis
Peritonitis
Bowel resection or anastomosis
Pelvic radiation
Inflammatory bowel disease
Multiple cesarean sections
Appendicitis with perforation
Genetic fibrosis predisposition

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent bowel obstruction symptoms
  • Persistent or worsening abdominal pain
  • Inability to pass gas or stool
  • Vomiting with abdominal distension
  • Weight loss without other cause
  • Suspected mechanical obstruction
  • Infertility evaluation in women with prior surgery
  • Severe pelvic pain refractory to medical therapy

Treatment Methods

01
Trial of conservative management for partial obstruction
02
Nasogastric decompression
03
Laparoscopic adhesiolysis when feasible
04
Open adhesiolysis for complex or recurrent cases
05
Bowel resection if irreversible ischemia
06
Adhesion-prevention barriers and solutions
07
Minimal handling of bowel intraoperatively
08
Multidisciplinary management for chronic pain
09
Postoperative early ambulation and feeding
10
Long-term follow-up for recurrence

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.