What is laparoscopic adhesiolysis?
Adhesiolysis is the surgical division of adhesions that have formed after previous operations, inflammatory processes, injuries, or peritonitis.
During the operation, the following may be released:
- adhesions between bowel loops
- adhesions between the bowel and the front abdominal wall
- pelvic adhesions
- adhesions between the bowel and other abdominal organs
The goal of the procedure is to restore normal bowel mobility and remove the mechanical obstruction.
Our approach
At MSI, adhesive disease is treated in line with modern guidelines from the *EAES, SAGES, and WSES* and the principles of minimally invasive surgery.
Before surgery, a comprehensive examination is carried out, which may include:
- computed tomography
- laboratory tests
- ultrasound
- endoscopic examinations, when indicated
*In the absence of contraindications, we aim to perform adhesiolysis laparoscopically.* If massive adhesions, bowel necrosis, or other complex changes are found during surgery, conversion to open surgery may be needed.
Postoperative treatment follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
When is surgery needed?
Laparoscopic adhesiolysis is performed for:
- adhesive bowel obstruction
- recurrent episodes of partial obstruction
- chronic pain associated with adhesions
- fixed bowel loop syndrome
- certain cases of female infertility associated with pelvic adhesions (in collaboration with gynecologists)
Indications for surgery
Surgery is recommended for:
- confirmed adhesive obstruction
- ineffective conservative treatment
- repeated hospitalizations due to adhesive disease
- persistent symptoms that significantly impair quality of life
How is the operation performed?
The procedure is performed under general anesthesia.
Laparoscopic instruments and a camera are inserted through a few small punctures. After the abdominal cavity is explored, the surgeon divides the adhesions step by step, freeing the bowel and other organs.
Special attention is paid to preventing injury to the bowel and blood vessels.
If an irreversibly damaged segment of bowel is found during surgery, it may need to be resected.
Advantages of laparoscopic surgery
- Minimal surgical trauma
- Less postoperative pain
- Lower risk of new adhesions than with open surgery
- Faster return of bowel function
- Shorter hospital stay
- Better cosmetic result
- Faster return to everyday activities
Recovery after surgery
Postoperative treatment follows *ERAS* principles.
Patients are mobilized early and gradually resume eating and physical activity. The length of the hospital stay depends on the extent of the adhesions and the complexity of the procedure.
Our advantages
- Extensive experience in laparoscopic abdominal surgery
- A commitment to minimally invasive surgery
- A gentle tissue-handling technique
- Maximum preservation of the bowel
- Readiness to perform bowel resection if necessary
- Adherence to EAES, SAGES, and WSES international guidelines
- Enhanced recovery program (ERAS)
Frequently Asked Questions
The operation removes existing adhesions, but it is impossible to completely rule out the formation of new ones. The laparoscopic approach significantly reduces this risk compared with open surgery.
No. Asymptomatic adhesive disease does not require surgical treatment. Surgery is indicated only when adhesions cause obstruction, severe pain, or other clinically significant symptoms.
Yes. If necrosis, perforation, or irreversible damage to the bowel is found, the affected segment is resected.
Yes. If continuing laparoscopically becomes unsafe because of massive adhesions or other technical difficulties, the operation is converted to open surgery.
After an uncomplicated laparoscopic adhesiolysis, most patients return to normal activities within *2--3 weeks*.