Resection of pelvic adhesions
Adhesions are bands of scar tissue formed inside the abdomen. They are not part of the normal anatomy meaning that most of them don’t exist at birth.
Adhesions cause problems for millions of women around the world. They might be far more extensive than the clinical symptoms experienced, or at the same time, the symptoms might start many years after their development. Usually, the lining of the abdominal cavity, which is called the peritoneum, doesn’t involve adhesions, and adjusting organs of the abdomen lay one next to the other. When adhesions are formed the structures become fixed to parts of the abdomen causing problems (i.e., pain, complications from the bowel, infertility, etc.)
How do adhesions form ?
The reason for the formation of adhesions is not always known. Typically an inflammation process should interfere. Inflammation might involve a previous surgery in the abdominal cavity, and pelvic inflammatory disease, endometriosis, appendicitis, etc.
Unfortunately, there is no imaging process to diagnose adhesions with high accuracy. MRI or ultrasound might miss the diagnosis of adhesions in a patient with chronic pelvic pain. Detailed medical history and medical examination as well as diagnostic laparoscopy- plus or minus biopsies – will set the final diagnosis and deliver the treatment.
During operating procedures, specific techniques can be used to prevent the formation of adhesions. On top of that, special materials can be used that are called adhesion barriers. This might be in the form of a liquid that causes the dilution of the particles that cause adhesions, hence minimize their formation or even solid components that can be placed on top of surgical incisions and wounds and eventually reduce exposure to the lining of the abdominal cavity.
Symptoms of adhesions
Adhesion formation can have a detrimental effect on family planning and infertility as well. Studies suggest that adhesions may block the fallopian tubes and prevent fertilization. Early detection of the causes that might lead to adhesions will prevent their formation or at least minimize their extent. Therefore, firstly tests for sexually transmitted diseases that might lead to pelvic inflammatory disease should be performed on a regular basis with the initiation of clinical symptoms. Secondly, adhesion barriers should be placed in case surgery is performed. Thirdly, especially in young patients, surgery should be performed only when needed protecting women from entering the vicious cycle of adhesion formation.
Benefits from adhesion removal / adhesiolysis
Studies suggest that surgical removal of adhesions reduces pain and increases fertility as well as spontaneous conception.
In case this kind of surgery is needed, removal of adhesions will free bowel loops from connecting to the abdominal cavity or other adjusting organs and fallopian tubes from being stuck to the pelvic sidewalls. The gold-standard procedure is through keyhole surgery, and we can offer to our patients this service through robotic-assisted laparoscopy.
Robotic surgery, by its precise movements, maximizes our ability to offer high-level services by increasing surgical capabilities that can meticulously and safely take down all adhesions formed.
Robotic-Assisted Laparoscopic Excision of Adhesions
Surgeons dedicated to performing minimally invasive procedures are committed to personalized treatment for every individual patient. Robotic-assisted procedures are considered safe and effective. It is appropriate for most patients, but not for all.
Let’s discuss your treatment options.
If you are a surgical candidate for robotic surgery, skilled robotic surgeons with high-end equipment will be able to offer you treatment and relief of your symptoms.