Lysis Of Abdominal Adhesions

What you should know

• Adhesions are bands of scar tissue that can grow anywhere inside your body. Common places for adhesions to grow are in your abdomen and pelvis. The pelvis is the lower abdomen area between your hips. Adhesions can cause organs and surrounding tissue to be twisted, pulled out of place or stuck together. Adhesions are caused by body tissue injury. The growth of adhesions depends on how your body reacts to the tissue injury.
  
  
• Causes of adhesion growth are surgery and radiation therapy. Other causes of adhesions are diseases and infections that lead to irritation and damage of the organs and tissues. Examples of these are endometriosis and pelvic inflammatory disease (PID). Adhesions can cause infertility (being unable to get pregnant), blocked intestines and pain. Caregivers may remove your adhesions during a procedure called adhesiolysis (ad-he-zee-oh-LEYE-sis).

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• There are always risks with surgery. You could bleed too much or have breathing problems. You may have an allergic reaction to a medicine that caregivers give to you. You may get an infection. Your intestines may slow down after surgery, causing bloating and discomfort. Organs such as the liver, lungs, and spleen could be damaged during surgery.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• After surgery, you may get an incisional hernia (weak area around the incision). More adhesions (scar tissue) may grow where the surgery was done, or you may still have pain. You may need to have more surgery done for adhesions at a later time.

Getting Ready

The week before your surgery:

• You may need to stop using certain over-the-counter medicines for a time before your surgery. If your caregiver has told you to take aspirin daily, do not stop taking it without asking first.
  
  
• Tell your caregiver about any over-the-counter vitamins, herbs, food supplements, or laxatives you are using. These medicines may not work well with medicines you may need during surgery.
  
  
• You may need to have blood tests, x-rays or other tests before your surgery. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• Take any medicine that your caregiver has given you to take before surgery exactly as ordered.
  
  
• Arrange to have a family member or friend to drive you home when you leave the hospital. Do not drive yourself home.
  
  
• Your caregiver may want you to empty and clean out your bowel before surgery. Doing this may stop your bowel from getting infected after surgery. Your caregiver may ask you to do one or more of the following things:
  
  
  • Eat high fiber foods for 1 to 2 days before surgery. Good examples of high fiber foods are fruits, vegetables, and whole-wheat cereals and breads. Drink 6 to 8 (eight-ounce) cups of healthy liquids each day, unless your caregiver tells you not to.
    
    
  • Take medicine called a cathartic the day before surgery. A cathartic will make you have diarrhea (loose, watery stools), but it will clean out your bowel quickly.

The night before your surgery:

• Try to get enough restful sleep before your surgery. You may be given a pill help you sleep.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of surgery. These medicines include insulin, diabetic pills, blood pressure pills, and heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses on the day of the procedure. You may wear glasses.
  
  
• An anesthesiologist will talk to you before your surgery. This caregiver may give you medicine to make you sleep during surgery.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do surgery. It also explains the problems that may happen with your surgery, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a cart to the operating room. You will get medicine called anesthesia to prevent pain or keep you completely asleep during surgery. Caregivers will clean your abdomen with a special soap before surgery to get rid any germs on your skin. Sheets are put over you to keep the surgery area clean.
  
  
• Your surgeon will make several small incisions in your abdomen if he is doing a laparoscopy. He may make one large incision (cut) in your abdomen if doing a laparotomy. The surgeon will look for adhesions and remove them by cutting, burning or vaporizing them (with a laser). He may insert a barrier to prevent adhesions from forming again. When the surgeon is finished with the surgery, he will close your abdomen. Then the caregivers will use sutures (stitches), staples, adhesive strips or a special surgery glue to close the skin incision.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. If you had general anesthetic, an adult will need to drive you home. Your driver or someone else should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You have questions or concerns about your surgery.
  
  
• You have a fever.
  
  
• You cannot make it to your surgery appointment on time.
  
  
• The problems for which you are having surgery get worse.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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