Gynaecology
Laparoscopy for Division of Adhesions
You will be asleep during the procedure with a general anaesthetic administered by a needle into a vein. One or more small cuts - about 5 to 15 mm in length will be made in your abdominal wall. A gas will be introduced into the abdomen in order to lift the abdominal wall up. A telescope will be put into one of the cuts and scissors, forceps or diathermy needle through the other cuts.
Bands of scar tissue or adhesions, which can be identified, will be cut and removed and the abdomen washed out. The cuts will be closed, usually with dissolvable stitch or sticky tape.
Anaesthetic
See “About your anaesthetic” information sheet for information about the anaesthetic and the risks involved. If you have any concerns, talk these over with your anaesthetist. If you have not been given an information sheet, please ask for one.
General Risks Of A Procedure
They include:
• Small areas of the lungs may collapse, increasing the risk of chest infection. This may need antibiotics and
physiotherapy.
• Clots in the legs with pain and swelling. Rarely part of this clot may break off and go to the lungs which can
be fatal.
• A heart attack because of strain on the heart or a stroke. − Increased risk in obese people of wound infection,
chest infection, heart and lung complications and thrombosis.
• Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.
• Death is a very rare risk.
Risks Of This Procedure
Adhesions are difficult to diagnose with certainty without surgery and there is no alternative treatment for adhesions other than surgery.
It should be understood that the adhesions can be the result of surgery and it cannot, therefore, be guaranteed that they won’t come back after surgery to treat them.
Sometimes a single band of tissue that is causing the bowel to twist or kink causes the problem. In that case, successful treatment is very high. Other cases, however, are caused by many filmy adhesions and these are much more difficult to get rid of.
The main risks and complications for laparoscopic surgery are:
• Accidental injury to the bowel, blood vessels and the urinary tract can occur during the passing of the
laparoscope.
• If a complication happens during the surgery, then repair is usually possible at the time - often through the small
cuts. However, it may also be necessary to make a larger cut to repair the bowel, blood vessel or urinary tract
injuries.
• In case of bowel injury, it may be necessary for the bowel to be brought out onto the abdomen. This allows
waste to drain into a bag worn over the end of the bowel (known as a colostomy) so the injured bowel can heal.
This colostomy would normally be closed at a separate operation.
• Infections such as pus collections in the abdominal cavity. This may need surgical drainage and antibiotics.
• In some people, healing of the wound may be abnormal and the wound can be thickened and red and the scar
may be painful.
• A weakness in the wound with the development of a hernia. This may need further surgery. − Very low
possibility of a fistula (a connecting passage between one area and another) developing.
Laparoscopy Diagnostic