Laparoscopic adhesiolysis

When I had laparoscopic kidney surgery plenty of adhesions were lysed on the way, but only to "clear the path." My only caveat would be that it's probably  harder to spot specific troublemakers laparoscopically. If your surgeon hasn't been trained to do it then it won't be his go-to approach, even if it's a bit better overall.

Scott F posted:

When I had laparoscopic kidney surgery plenty of adhesions were lysed on the way, but only to "clear the path." My only caveat would be that it's probably  harder to spot specific troublemakers laparoscopically. If your surgeon hasn't been trained to do it then it won't be his go-to approach, even if it's a bit better overall.

Thanks for your input, Scott. I will see the surgeon on March 10 and ask him all about it.

Somehow I feel that I can face having my pouch diverted to an ileostomy, but can't cope with the idea of having my abdomen opened up again. Given that I have had an ileostomy before (so won't need as long to get used to it as a newbie) I imagine that I could get home much sooner if the adhesiolysis could be done laparoscopically.

I think you might need to find a different doctor.  I had all open surgeries, hysterectomy related 20 years ago then 5 years ago had 3 surgeries in 8 months. They were my colonectomy, take down and incisional hernia.  5.5 months ago I had surgery to divert from using my j-pouch to a permanent ileostomy.  I was hoping that I wouldn't need the j-pouch removed. I am now getting it removed next month

My current surgeon is at the Mayo Clinic and she went in and laproscopically spent 3 hours lysing, adhesiolysis , my the adhesions plus peeling my intestines from the hernia mesh.  The surgery was to be 1.5 hours but she spent 4.5 hours because  of my abdomen full of adhesions.   I think that many doctors would have done the minimum getting to my j-pouch inlet. They can grow back over time but my lumpy bumpy and knotty abdomen is better.  I can feel them gone!

I know how painful they can be.  I have been on Norco pain medication for 5 years. The doctors thought the pain was due to the adhesions.  In testing for partial obstructions my local surgeon had a small bowel study done.  It took the barium water 2.5 hours to do what took 30 minutes the year before.  That was just water and not what happens when eating food. I have not been in contact with him since then.  I feel very strongly about this. I wish I had been told my colonectomy and j-pouch surgeries could have been done laproscopically.  If I knew that I would have gone to the Mayo Clinic in the first place.  My local surgeon trained at the Cleveland Clinic so I thought it better to have it around home instead of 3.5 hours away at the Mayo Clinic.  

I feel very strongly about this.  Years in pain that might have been less or not at all.  Please check for a different surgeon that will be patient enough to take care of your adhesions laptoscopically!!!

It is probably better I did these surgeries in 2 parts because of the adhesions.  Life is short. Don't worry about offending your surgeon. A good doctor is one that is not threatened by a patient seeking another opinion.  My local GI sent me to Mayo's for my second opinion when my UC was diagnosed.  He sent me back again when he didn't feel he knew enough to help me with my cuffitis.  This was after it had been treated for around 5 months.

Good Luck!

TE Marie, thank you for sharing your experience. My goodness, you have had a tough time. It sounds like you currently have a team you can trust with your surgeon at the Mayo Clinic and your GI.

I have been fortunate in that if I do have adhesions, they haven't caused me any major pain or problems (apart from the occasional agonising jab when I sneeze or roll over oddly in bed).

I'm in Australia and am having my operation through the public system, so I am not sure whether I can "shop around". However, I have a good relationship (long standing!) with my surgeon, so he is used to me asking lots of questions.