Adhesions & post- Laparoscopic complications

From: Vict. (
Sun Apr 23 18:12:13 2000

Hi, I just wanted to put out a word of general caution. There are times that lap surgery of any type is appropriate for adhesion lysis. There are certain individuals that due to the severity of their adhesions should not be subjected to laparoscopic surgery...especially if that laprascopist's experience is limited to a typical gyn practice. There are lap docs who confine their surgery to scope surgery only. I am NOT saying that a gyn could not do the surgery. What I am trying to get across is there are cases of severe adhesions that first of all surgery will not help...that will actually produce more adhesions. The hard evidence I've seen states that: Laparoscopic surgery is associated with a lower incidence of wound adhesion. It is not associated with a lower incidence of actual internal abdominal adhesions. If you have severe dense adhesions you really need to weight the potential risks. There are serious complications associated with this type of surgery. Most physicians and patients have an attitude that after the surgery is over and they are 7 or more days post-op, "hey, no problem". They don't relate symptoms that crop up to the surgery. This can be really bad news. People have not survived due to this attitude. If you are even 14 days post op and you begin feeling a bit ill, have a fever, nausea, vague abdominal pain, dehydration, or other symptoms you need to rule out the possibility of post op complication. This means it must be diagnosed and ruled not to be associated with surgery. There is a gentleman who almost died one year after an apendectomy...the area walled off and formed an abcess which later burst. Complications can include perforated bowel or other organs, infection, bleeding, etc. You may have symptoms of a "PID" and the doc will say it was because you are not clean or due to sex...etc. That it was caused by bacteria entering the vagina and traveling up as far as the tubes...reality is that it can be caused from the inside can be caused by surgical contamination. Many times the scope will keep fogging up...I know of someone who became ill after a microscopic piece of fiber somehow became inbedded (?) in the bowel wall and became infected. There are really more cases out there than previously believed. The real "Experts" know about these cases. They know how many scope surgeries have been converted to open procedures...

I just feel that a woman or man, as it affects them too, should be fully aprised of their particular case and the benefits vs risks of a particular type of surgery along with a realistic discussion of the potential complications.

A for instance. The risk of perforated bowel, infection, or bleeding from a scope surgery is fairly low. They happen but the risk is fairly low...generally speaking. If you have severe, dense, adhesions that obliterate (make it so the surgeon cannot identify planes)then you do not fall in that generally speaking category. Of course this can be dependant upon where the adhesions are located, which ones the surgeons attempt to lyse, what type of instruments, cautery devices, or lasers they choose to use, and laparoscopic skill...Calling oneself an expert is oftentimes subjective. The surgeon may have only two years experience, he does 10 tubal ligations with a scope on virgin abdomens per week, and a few other scope surgeries...this does not an expert make...there are actual levels of competancy...Level one, level two, etc. Your idea of an expert may be 8 years or more experience and his may be one or two courses and a couple scope surgeries per week. I am NOT out to bash doctors...I have doctors too...I am out to hopefully educate women...I have huge amounts of info...and "inside" info that women and men must be aware of before undergoing lap surgery. I've heard all the pros and cons and then some...

Anyway, if you have a complicated belly then the risk goes up for you and is directly related to how complicated your belly is. The complications are life and death situations that generally are not caught at the time of surgery. If you are two weeks post-op you and the surgeon may not be looking at the possibility of surgical complications thus placing you in jepardy. Also remember that you may or may not have temporary relief...For me personally, unless I had a bowel obstruction, stricture, etc. then I cannot subject myself to any more. There are advantages to open procedures too. It's just hard to judge.

I feel it is ever so important that post-scope patients be given at discharge a list of potential symptoms of post-op complications...not just the standard or typical post-op instructions but ones that are specifically written for that specialized type of surgery. It would also be helpful if your doctor discussed with you precisely what he did in there...did he have a tough time with anything in particular, was the surgery difficult or easy? Did he at any time think he should back out?

I've heard the positive outcomes but I also know of the potential complications...

Just be careful...really check it out...I don't want any of you sustaing serious damages.

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