What is Laparoscopic Lysis of Abdominal Adhesions

Laparoscopic lysis of abdominal adhesions is a surgical procedure to remove tough (fibrous) bands of tissue from the abdomen. Adhesions are like scars, but they form on the inside of the body.

They are caused by inflammation and often develop after a previous surgery or infection as part of the healing process. You may need this procedure if you have abdominal adhesions that are causing pain or other symptoms.

During the procedure, the surgeon inserts a thin tube that has a light and camera on the end of it (laparoscope) into the abdomen. The camera sends images to a screen in the operating room, and these images are used to help guide the surgery. This type of surgery is done through small incisions, rather than one large incision.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to abdominal organs.
• Development of more abdominal adhesions.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• You may have imaging tests and blood tests.
• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic).
• A tube may be passed through your nose and into your stomach (nasogastric tube).
• The surgeon will make a small incision through the wall of your abdomen.
• Your abdomen will be filled with a gas. This will help your surgeon see the inside of your abdomen more clearly. It will also give the surgeon more room to operate.
• A laparoscope with a camera on the end will be passed through the incision. It will send images to a monitor in the operating room.
• Other small incisions may be made in your abdomen. Long, thin surgical instruments will be inserted through them as needed.
• The adhesions will be cut with surgical scissors or removed with some form of energy, such as electric current or laser energy.
• The incisions will be closed with adhesive strips or stitches (sutures).
• A bandage (dressing) will be placed over the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You may have some pain. You will get pain medicine as needed.
• You will be encouraged to get up and walk around while you are still in the hospital.
• If you have a nasogastric tube, it will be removed when your bowel function returns. After that, you will be allowed to eat or drink as usual.
• When you are taking fluids well, your IV will be removed.

Summary

• Laparoscopic lysis of abdominal adhesions is a surgical procedure to remove scar tissue (adhesions) from inside your body.
• You may need this procedure if you have abdominal adhesions that are causing pain or other symptoms.
• After surgery, you will receive medicines and fluid by vein until your bowel function returns to normal. After that, you will be allowed to eat or drink as usual.

Laparoscopic Lysis of Abdominal Adhesions, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have some pain around your incisions.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision areas every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not drive or use heavy machinery while taking prescription pain medicine.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• After your procedure, eat only a little at a time at first. Start with liquids. As your appetite improves, gradually return to eating solid foods.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You have redness, swelling, or pain at the site of your incisions.
• You have fluid or blood coming from your incisions.
• Your incisions feel warm to the touch.
• You have pus or a bad smell coming from your incisions or the dressing.
• Your pain gets worse.
• You have a cough.
• You have nausea and vomiting that does not go away after 3 hours.

Get help right away if you have:

• Severe pain in your abdomen or your chest.
• Shortness of breath.
• Nausea or vomiting that is severe or keeps coming back.

Summary

• After laparoscopic lysis of abdominal adhesions, it is common to have some pain around your incisions.
• Check your incision areas every day for signs of infection. Watch for redness, worsening pain, warmth, and drainage.
• Be sure to keep all follow-up visits as told by your health care provider.