Laparoscopic Adhesiolysis: Expert Care for Adhesion Removal

Laparoscopic adhesiolysis is a minimally invasive surgery that removes internal scar tissue (adhesions) formed after infections, inflammation, or previous surgeries. These adhesions can cause pain, bowel obstruction, or infertility.

• Why it’s needed: To relieve chronic abdominal or pelvic pain, restore organ mobility, and improve fertility outcomes.
• How it’s done: Through tiny incisions, using a camera-guided laparoscope and precision instruments for safe adhesion removal.
• Benefits: Faster recovery, less pain, minimal scarring, and lower risk of recurrence compared to open surgery.

Adhesions are bands of scar tissue that form inside the body, often after inflammation or surgery. They commonly develop on the inner lining of the abdomen and may connect:

• Organs within the abdominal cavity
• Loops of intestines, causing bowel obstruction
• The abdominal wall and internal organs
• Fallopian tubes and ovaries, affecting fertility
• Uterus and abdominal wall, especially after cesarean section

Why It Happens: Adhesions form as part of the body’s healing response to surgery, infection, or inflammation.

Adhesions are internal scar tissues that may cause symptoms ranging from mild discomfort to life-threatening complications. Common symptoms and risks include:

• Chronic abdominal or pelvic pain: Persistent discomfort that worsens over time
• Bowel issues: Constipation, bloating, or intestinal obstruction
• Infertility: Adhesions can block fallopian tubes, preventing conception
• Pain during movement or sex: Due to internal organ tethering
• Severe complications: Bowel obstruction, organ damage, or frozen pelvis in advanced cases

Tip: Early detection and treatment with laparoscopic adhesiolysis can prevent these risks and restore normal function.

Laparoscopic adhesiolysis is recommended when adhesions cause pain or complications that affect quality of life. Common indications include:

• Chronic lower abdominal or pelvic pain
• Abnormal bowel movements or bloating
• Infertility due to adhesions affecting fallopian tubes
• Severe pain not relieved by medication
• Intestinal obstruction causing vomiting, pain, or inability to pass stool

Tip: Early intervention can prevent life-threatening complications like bowel strangulation.

Adhesiolysis can be performed through different techniques depending on the location of adhesions and the organs involved:

• Pelvic Adhesiolysis: This laparoscopic procedure removes adhesions formed in the pelvic region, often due to endometriosis, infections, or prior surgeries. It helps relieve pain and improves fertility.
• Hysteroscopic Adhesiolysis: This minimally invasive surgery removes adhesions inside the uterus using a hysteroscope. Uterine adhesions (Asherman’s syndrome) can cause infertility, menstrual irregularities, and pregnancy complications.

Goal: Both methods aim to restore normal organ function, reduce pain, and improve reproductive outcomes.

Laparoscopic adhesiolysis is recommended for patients who experience significant symptoms or complications due to adhesions. You may be an ideal candidate if you have:

• Chronic abdominal or pelvic pain: Persistent discomfort impacting daily life
• Bowel obstruction or severe constipation: Caused by intestinal adhesions
• Infertility: When adhesions block fallopian tubes or distort pelvic anatomy
• Pain during movement or intercourse: Suggesting organ tethering by adhesions
• Failed medical management: No improvement with medications or conservative measures

Note: Patients must be medically fit for anesthesia and have realistic expectations about outcomes.

Before undergoing laparoscopic adhesiolysis, proper preparation ensures a safe procedure and smooth recovery. Here’s what you can expect:

• Medical reports: Bring all investigations, including complete blood count, liver, kidney, thyroid function tests, and chest X-ray.
• Dietary instructions: Follow a light diet a day before surgery and avoid milk or dairy products to prevent bloating.
• Medication adjustments:
  • Stop estrogen-containing medications 1 month before surgery.
  • Discontinue blood thinners like aspirin at least 1 week before surgery.
  • Continue essential medicines for thyroid, blood pressure, and diabetes as advised.
• Health monitoring: Report any signs of illness such as fever, cough, or infection before surgery.
• Bowel preparation: A bowel-cleansing solution is given the night before surgery to reduce bloating and ensure better visibility during the procedure.

Tip: Following these steps helps minimize complications and ensures faster post-operative recovery.

Laparoscopic adhesiolysis is a minimally invasive surgery done under general anesthesia to remove scar tissue (adhesions) safely. Here’s the step-by-step process:

• Step 1: The procedure is performed under general anesthesia in an advanced operating room.
• Step 2: A small incision is made near the umbilicus, and the abdomen is inflated with CO₂ gas for better visualization.
• Step 3: A fiber-optic laparoscope is inserted to inspect abdominal and pelvic organs.
• Step 4: Two or three additional tiny incisions are made to insert specialized laparoscopic instruments.
• Step 5: The surgeon maps the extent and nature of adhesions, noting their proximity to vital organs and blood vessels.
• Step 6: Adhesions are carefully cut using either cold scissors or electrosurgical instruments, ensuring safety and reducing recovery time.

Goal: Restore normal anatomy, reduce pain, and prevent future complications while minimizing surgical trauma.

Recovery after laparoscopic adhesiolysis is generally quick, but mild discomfort is common. Here’s what to expect:

• Observation: You’ll stay in the recovery room for about 2 hours after waking from anesthesia before moving to your room.
• Mild shoulder or back pain: Caused by the CO₂ gas used during surgery; it usually subsides in 24–48 hours.
• Tiredness or mild incision discomfort: Normal for a few days post-surgery; improvement occurs daily.

When to call your doctor: Seek immediate help if pain persists or is associated with nausea, vomiting, or other unusual symptoms.

Recovery after laparoscopic adhesiolysis is typically quick, and most patients can return home within 24 hours. Here’s what to expect:

• 6 hours after surgery: Start with clear liquids, then transition to a light diet as tolerated.
• Early mobility: Walking is encouraged on the same day if no urinary catheter is present.
• If a catheter is used: It is usually removed the next day, after which you can move around comfortably.
• Discharge: Most patients are discharged the next day after ensuring stable recovery and minimal discomfort.

Tip: Follow post-discharge instructions for medications, wound care, and follow-up visits to ensure a smooth recovery.

Laparoscopic adhesiolysis is generally safe, but like any surgery, it carries certain risks. These include:

• Bleeding or infection: May occur at incision sites or internally
• Injury to nearby organs: Rare damage to bowel, bladder, or blood vessels
• Recurrence of adhesions: Scar tissue can form again over time
• Adhesion-related pain: Persistent discomfort in some cases
• Anesthesia-related complications: Rare allergic reactions or breathing issues

Tip: Choosing an experienced laparoscopic surgeon minimizes these risks and ensures better recovery.

While adhesions often result from surgery or infection, certain lifestyle measures can reduce risk and recurrence:

• Stay active: Gentle movement after surgery promotes healing and reduces scar tissue buildup
• Balanced diet: Include fiber-rich foods to prevent constipation and abdominal strain
• Avoid smoking: Smoking delays wound healing and increases adhesion risk
• Manage infections promptly: Treat pelvic infections early to prevent inflammation-related adhesions
• Regular check-ups: Post-surgery monitoring ensures early detection of recurrence

The cost of laparoscopic adhesiolysis in Mumbai depends on case complexity, hospital facilities, and room selection. At Vardaan Hospital:

• Economy Ward: ₹50,000 onwards
• Semi-Special Room: ₹70,000 – ₹85,000
• Deluxe Room: ₹1.2 lakh
• Suite Room: ₹1.8 lakh and above

Includes: Surgeon’s fee, OT charges, anesthesia, medicines, and one-day hospital stay. Additional costs may apply for extended care or complications.

Dr. Dimple Doshi is a leading gynecologist and laparoscopic surgeon in Mumbai with expertise in managing complex adhesions using advanced technology.

• 27+ years of experience in gynecologic and laparoscopic surgeries
• Expert in fertility-preserving and minimally invasive techniques
• Uses Karl Storz Rubina 4K 3D system for precision and safety
• Performed 25,000+ successful laparoscopic procedures
• Comprehensive pre-op counseling and post-op care for better recovery

ICD-10 Codes for Adhesions and Related Conditions

CPT Codes for Laparoscopic Adhesiolysis

Q1. What is the recovery time after laparoscopic adhesiolysis?

Q2. How long does laparoscopic adhesiolysis surgery take?

Q3. How painful is laparoscopic adhesiolysis?

Q4. Can adhesions come back after surgery?

Q5. Is laparoscopic adhesiolysis a major surgery?

Q6. How do I prevent adhesions after surgery?

Q7. Can I get pregnant after adhesiolysis?

Q8. How long does it take to heal internally after adhesiolysis?

Q9. What should I eat after laparoscopic adhesiolysis?

Q10. Does laparoscopic adhesiolysis leave scars?

Q11. How soon can I walk after laparoscopic adhesiolysis?

Q12. Can adhesions cause infertility?

Q13. Are adhesions life-threatening?

Q14. How much does laparoscopic adhesiolysis cost?

Q15. Can adhesions be cured permanently?

Q16. What are the early signs of post-surgical adhesions?

Q17. Is walking good for abdominal adhesions?

Q18. Can adhesions form after a C-section?