What is open adhesiolysis?
During the operation, the surgeon divides the abnormal adhesions step by step between:
- bowel loops
- the bowel and the front abdominal wall
- the bowel and other organs
- the pelvic organs
The goal of the procedure is to eliminate the mechanical cause of bowel obstruction or chronic pain and restore normal abdominal anatomy.
If necessary, bowel resection, fistula repair, or other reconstructive procedures may be performed at the same time.
Our approach
At MSI, *our first choice is to perform adhesiolysis laparoscopically*, as it involves less surgical trauma and a lower risk of new adhesions.
Open surgery is performed when it is the safest or the only possible treatment.
Before a planned procedure, a comprehensive examination is carried out, which may include:
- computed tomography
- laboratory tests
- ultrasound
- endoscopic examinations, when indicated
In acute bowel obstruction, the decision to operate is made urgently.
Postoperative treatment follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
When is surgery needed?
Open adhesiolysis is performed for:
- massive adhesions
- acute adhesive bowel obstruction
- suspected bowel ischemia or necrosis
- multiple postoperative adhesions
- recurrent obstruction after previous operations
- cases where a laparoscopic procedure is impossible or unsafe
Indications for surgery
Surgery is recommended for:
- complete bowel obstruction
- ineffective conservative treatment
- signs of bowel ischemia or necrosis
- recurrent episodes of adhesive obstruction
- complex postoperative changes in the abdominal cavity
How is the operation performed?
The procedure is performed under general anesthesia.
The abdominal organs are explored through a laparotomy incision. The surgeon divides the adhesions step by step, restoring bowel mobility and removing the mechanical obstruction.
If necessary, the following are performed:
- resection of a non-viable bowel segment
- creation of an intestinal anastomosis
- repair of intestinal fistulas
- other reconstructive procedures
Advantages of open surgery
- Treatment of the most complex forms of adhesive disease
- Full view of the abdominal organs
- Reliable elimination of massive adhesions
- Bowel resection or other complex operations can be performed at the same time
- Optimal control in severe bowel obstruction
Recovery after surgery
Postoperative treatment follows *ERAS* principles.
The length of the hospital stay depends on the severity of the disease, the extent of the operation, and the need for additional reconstructive procedures.
Special attention is paid to early mobilization, a gradual return to eating, and prevention of new adhesions.
Our advantages
- Extensive experience in treating complex adhesive disease
- A commitment to laparoscopic surgery whenever possible
- Open procedures for the most complex clinical cases
- Reconstructive bowel surgery can be performed at the same time
- Adherence to EAES, SAGES, and WSES international guidelines
- Enhanced recovery program (ERAS)
Frequently Asked Questions
With massive adhesions, bowel ischemia, necrosis, or severe bowel obstruction, the open approach allows the operation to be performed more safely and the cause of the disease to be eliminated completely.
Not always. Sometimes the decision to use an open approach is made before surgery based on examination results, and sometimes a laparoscopic procedure is converted for the patient's safety.
Yes. New adhesions cannot be ruled out completely, but the gentlest possible tissue-handling techniques are used during surgery to help reduce this risk.
Yes. If a non-viable segment of bowel is found during surgery, it is removed and bowel continuity is restored, or a stoma is created if necessary.
After open adhesiolysis, full recovery usually takes *4--8 weeks*, depending on the complexity of the operation and the patient's general condition.