Laparoscopy – Adhesions
Adhesions are bands of scar tissue which can form following previous surgery. They are most common after open procedures (laparotomy). Adhesions are less common after laparoscopic procedures because the organs (bowel and ovaries) are handled less and there is significantly less trauma.
Surgical techniques used in laparoscopy achieve meticulous control of even minimal bleeding which will minimise the risk of adhesions forming.
This is one major reason why Dr Cook prefers laparoscopy over laparotomy (open procedure). Adhesions can also form following infection (including appendicitis) and inflammation (including endometriosis). Adhesions can involve any organ but most commonly the ovaries and the bowel. Particular care is taken in the division of adhesions to prevent damage to adjacent structures including bowel.
Dr Cook has particular expertise in laparoscopic adhesiolysis (division of adhesions).
Symptoms of adhesions can include pain and infertility. Some women present with bowel related issues including constipation and even bowel obstruction.
The procedure to divide adhesions is most commonly performed for pain. Adhesiolsyis can also be required prior to another procedure. Adhesiolysis is commonly performed prior to Laparoscopic Pelvic Floor Repair in a woman who has previously had a Total Abdominal Hysterectomy.
Adhesiolysis is often performed during endometriosis surgery to liberate the bowel and allow full excision of the endometriosis. Filmy adhesions are often seen with Pelvic Inflammatory Disease. These are divided and antibiotics given. Anti-adhesion barriers and agents can be used to minimise the risk that the adhesions will grow back.