Lysis of adhesions by laparoscopy – what is it?
The abdominal cavity is confined by two sheets of the peritoneum, and containing the internal organs. Normally, these sheets freely slide relative to each other, but, in some cases, in the presence of predisposing factors that can form adhesions with each other or with the shell of organs, disrupting their work. This phenomenon is called adhesive disease.
The appearance of adhesions in the abdominal cavity is a protective mechanism of the body and exist in order to distinguish pathological lesion from healthy tissue. On the other hand, he adhesions can cause many problems.
The disease may be asymptomatic and does not deliver any discomfort, yet did not significantly affect the function of internal organs. Clinic adhesive disease may appear in the first month after surgery or injury, and may not manifest itself for many years.
Most often the symptoms that lead to treatment to the doctor, represent the clinic of intestinal obstruction.
Manifests itself adhesions abdominal pain. They can cause the appearance several types of intestinal obstruction:
- Obstructive ileus. When the obstruction is broken the passage of intestinal contents due to the narrowing of its lumen as a result of compression spikes, but the body blood circulation is not affected. Appear paroxysmal abdominal pain associated with peristalsis, and later joins vomiting. The abdomen is swollen the patient develops constipation. The doctor may notice increased peristaltic noises, sometimes peristalsis may be visible through the abdominal wall.
- Strangulation obstruction. As a result of pathological adhesions compressed the mesentery of the intestine, which can quickly lead to gangrene of the organ. Thus the patient against the background of complete well-being appear severe abdominal pain, vomiting, then usually followed by a period of «imaginary prosperity», when the pain does not bother me, but the General condition continues to worsen, symptoms of intoxication. This kind of obstruction is an indication for emergency surgical intervention.
If phenomena is no intestinal obstruction, adhesive disease doctor help determine these diagnostics, such as abdominal ultrasound, computed tomography, magnetic resonance imaging.
The doctors checked a lot of symptoms in the physical examination and x ray to clarify your diagnosis and the treatment aimed at the elimination of adhesions and treatment of acute intestinal obstruction.
Getting rid of adhesions
Depending on how soon after injury, surgery or infectious process, there was a clinic of adhesive disease is different treatment tactics. Adhesions:
- Which appear within the first weeks on the background of paresis of the intestine are treated conservatively. The main objective in this case ─ as soon as possible to restore normal bowel function.
- Appearing during the first weeks after surgery or injury in the early stages may be treated conservatively, the clinic needed intestinal surgery.
- Formed after a month or more after exposure, and having bright clinic of intestinal obstruction treated promptly.
For a long time, the main method of treatment of adhesive disease had an open laparotomy with dissection of adhesions. But no guarantees that it will prevent further formation of adhesions, it was not.
It laparoscopic surgery can not only confirm the presence of adhesions in the patient, but also to remove, causing minimal damage. Especially important is this kind of diagnosis and treatment of patients with the clinic of intestinal obstruction.
Further that it is. Idealizes by laparoscopy (incision of adhesions) is carried out in surgical departments when indicated. With the help of special tools included in the abdominal cavity and dissect adhesions. Such treatment causes the least recurrence compared to open surgery, because tissue damage is minimal.
In non-acute period adhesive disease it is possible to conduct laparoscopic operations that position the loop of the intestine in a special way to the newly emerging spikes were located in «profitable» for the body position.
But the laparoscopic method has limitations in its application, for example, when severe adhesions, severe stretching of the bowel loops and their vulnerability. In this case, the surgeon is more likely to take the decision to open surgery. In spite of this, laparoscopy is the most effective method of getting rid of adhesions at the moment.