Adhesions

Adhesions in the pelvis are scar tissues that form mainly as a result of inflammation produced by either infection, endometriosis or trauma from past surgery.

Causes of adhesions include:

Following surgery (post operative adhesions)
Endometriosis (chronic inflammation)
Infection such as pelvic inflammatory disease
Adhesions often do not cause symptoms though pelvic pain is the most common symptom

To diagnose, a history is taken to establish:

Pelvic pain
Symptoms of endometriosis (endometriosis may be found in association with adhesions)
Previous surgery

Treatment of adhesions:

A Laparoscopy may be indicated to diagnosis and divide adhesions.

Division of adhesions:

Laparoscopy (minimal access surgery) rather than a Laparotomy (larger abdominal incision) reduces the risk of further adhesions forming
Surgery takes 1-2 hours
Requires 1-2 nights in hospital, and 10 to 14 days off work

To reduce adhesions after surgery we ensure:

Use of laparoscopic surgery (minimal access surgery), which is known to cause less scarring and adhesion formation
Good surgical technique to minimise bleeding
The use of antibiotics to reduce the risk of infection
Relocation of ovaries which reduces the risk of adhesions forming in the pelvis
Instillation of a special fluid (Adept) into the pelvic cavity to bathe the tissues while healing

Relocation of ovaries involves:

Inserting a dissolving stitch into the ovary and attaching that stitch to a ligament which lifts the ovary away from the site of surgery. This reduces the risk of scarring between the ovaries and pelvic side wall. This is particularly useful in those women who have endometriosis excised from their pelvic side walls.
When the stitch dissolves 10 days later, the ovary returns to its normal position, but with a reduced risk of scar tissue forming. Sometimes a brief second look surgery is needed to confirm that the ovary has released itself back to its normal position.

Frequently asked questions about Adhesions

- Will medical insurance companies cover the procedures we offer?

In most cases the surgical procedures we perform are covered by medical insurance. It is important to obtain prior approval from your insurance company before surgery. Linda my Secretary will give you a breakdown of the costs related to your surgery.

- Do I need to have medical insurance?

No, medical insurance is not essential. However, it is important to obtain costings for the consultation and any proposed surgery prior to embarking on any course of action.

- If I am seen in Private can I be operated on by you in a Public Hospital?

Unfortunately I do not work in the Public Hospital system. In this instance I would refer you to the appropriate hospital depending on where you live in Auckland.

- I am concerned I will not be able to absorb all the information I am given during my consultation. How can I learn more about my condition and proposed management?

Studies have shown that at most we retain somewhere between 30-40% of what we are told at a medical consultation. For this reason we have developed this website so that information relevant to your condition is available to you at any time. You are encouraged to bring a support person to your consultation, as having two people will enhance retention of the information given. You will also be given written information at the conclusion of your consultation.

- What happens if I have any worries or concerns after surgery?

Written post-operative information will be given to you before going home, and these hand-outs can also be found on our website (view recovery guide). My telephone number is included in this information and I would encourage you to phone me if you have any concerns.

- Is minimal access surgery such as Laparoscopic surgery better than more conventional open surgery?

Minimal access surgery has the advantage of more precise surgery; less discomfort post operatively, shorter stay in hospital and early return to work.