Adhesiolysis is a surgical procedure to release adhesions inside the body, most often in the abdomen. Tissue bridges that have formed between organs or layers of tissue are carefully cut away to restore normal movement and function.
What are adhesions and why do they form?
Inside the body, especially after surgery or inflammation, tissue that should stay separate can sometimes join together. These connections are called adhesions. They are usually made of connective tissue and most often form in the abdomen, for example after appendix surgery, gynaecological procedures, or inflammation such as peritonitis.
Adhesions form as a natural response to injury or irritation. During the healing process, scar tissue develops and can cause organs or tissue layers to stick together. In many cases, these changes go unnoticed and cause no problems at all. Sometimes, however, they lead to difficulties such as pain, digestive problems, or even a bowel obstruction.
When is adhesiolysis necessary?
Not every adhesion needs treatment. Many are harmless and are often only found by chance. Adhesiolysis is considered when adhesions are causing symptoms or limiting the function of organs. Common reasons for the procedure include persistent abdominal pain, repeated digestive problems, or a bowel obstruction that is developing or already present. Adhesiolysis can also help when adhesions are affecting the fallopian tubes and causing difficulty conceiving.
Before such an operation, doctors carefully check whether the adhesions are truly responsible for the symptoms. This is usually done using imaging methods such as ultrasound, CT, or MRI. A definite diagnosis, however, is often only possible during a laparoscopy.
How is adhesiolysis carried out?
Adhesions can be released in two ways: using a minimally invasive approach through a laparoscopy, or through an open abdominal incision. The decision depends on how extensive the adhesions are, what symptoms are present, and whether the patient has had several previous operations.
During a laparoscopy, small cuts are made through which special instruments and a camera are inserted. The adhesions are carefully cut away to avoid injuring the surrounding organs. In some cases, a larger abdominal incision is needed, for example when the view is restricted or the procedure becomes very complex.
After the operation, most patients stay in hospital for a few days for observation. Recovery time depends on the extent of the surgery, but is often shorter after a laparoscopy than after open surgery.
Common questions and concerns about adhesiolysis
Many people feel worried when they are advised to have adhesiolysis. Concerns about undergoing another operation, about complications, or about whether the symptoms will actually go away are completely understandable. A common question is whether adhesions can come back after adhesiolysis. This is indeed possible, as any operation can lead to new adhesions forming. Modern surgical techniques and specific measures taken during the procedure are intended to reduce this risk.
Another concern is the question of risks. As with any operation, complications can occur, such as bleeding, infection, or injury to organs. Careful planning and experienced surgeons help to keep the risk as low as possible. Whether adhesiolysis is the right choice is always considered individually, depending on how severe the symptoms are and what alternatives are available.
Are there alternatives to surgery?
If symptoms are only mild, a wait-and-see approach is often taken first. Painkillers, dietary changes, or other supportive measures can help to ease symptoms. Surgery is generally only recommended when quality of life is significantly affected or serious complications such as a bowel obstruction are at risk of developing.
It is not currently possible to dissolve adhesions with medication. Alternative methods such as massage or specific diets cannot break down existing adhesions either, and at most may ease symptoms a little.
What should be considered after adhesiolysis?
After the procedure, it is important to allow the wound to heal well and to increase physical activity gradually. Diet is adjusted step by step so that the bowel can get used to functioning normally again. If there is ongoing pain, fever, or any other unusual symptoms, medical advice should be sought without delay.
Consistent follow-up care and regular check-ups help to identify any complications early. Even though adhesions can return, many people are free of symptoms for a long time after a successful adhesiolysis.
The decision to have this kind of operation is always made together with the treating doctor, with the aim of relieving symptoms as effectively as possible and improving quality of life.
