Definition - What does Adhesiolysis mean?
Adhesiolysis or lysis of adhesions is a surgical procedure that involves dividing or breaking down the adhesions or scar tissue to restore the normal anatomy and function of the abdominal and pelvic organs, including the capability to get pregnant. Adhesions are bands of scar tissue that form between the organs as part of the body’s natural healing mechanism. These may form in excess giving rise to pelvic adhesive disease. Adhesiolysis can help restore the reproductive potential in these women.
FertilitySmarts explains Adhesiolysis
Three modes of adhesiolysis are known: Open adhesiolysis, laparoscopic adhesiolysis, and hysteroscopic adhesiolysis. Laparoscopic adhesiolysis is preferred over the open approach due to the following reasons:
- Enhanced visualization and magnification of the adhesions and the abdominal/pelvic organs
- Less pain after surgery
- Less trauma to the abdomen, pelvis, and its covering
- Less bleeding
- Reduced odds of reformation of adhesions
- Reduced risk of bulging of an abdominal organ through the abdominal opening, called a hernia
- Shorter hospital stay
- Reduced time to recovery with earlier restoration of bowel function
In the laparoscopic approach, the surgeon first fills in the abdomen with gas. Ports are created in the abdomen through which laparoscopic tubes (with cameras) are inserted to visualize the abdominal organs and adhesions. With the help of scissors, adhesions are then dissected (or cut) while protecting the abdominal/pelvic organs from getting injured.
In hysteroscopic adhesiolysis, an instrument called hysteroscope is passed through the ports to visualize the uterus and dissect the adhesions. The reproductive outcome of women who undergo hysteroscopic adhesiolysis is excellent with about 97.2% of women being able to conceive within 2 years.
Who are the candidates for adhesiolysis?
- Women who are found to have pelvic adhesions during a diagnostic laparoscopy
- Women with a known history of pelvic adhesions secondary to diseases like pelvic inflammatory disease, endometriosis, or Asherman's syndrome (a condition in which adhesions develop within the uterus)
- Individuals with adhesion formation due to pelvic surgery or non-gynecological causes, such as after an abdominal surgery
Adhesiolysis can end up in serious complications, such as:
- Injury to the abdominal organs
- Bowel obstruction