-----Original Message-----
> From: Karla Nygren [SMTP:ifirgit@up.net]
> Sent: Monday, April 24, 2000 11:23 AM
> To: Multiple recipients of list ADHESIONS
> Subject: Re: Adhesions & post- Laparoscopic complications
>
> Laura,
>
> I think many of us have been told that we should never, ever have surgery
> again......me being one of them. Unfortunately, not all of us that
> option. The physician that I believe you are going to see is very
> skilled in laprascopy....and if he felt he could not handle your case he
> would not do it. He certainly would back out if he felt that he could
> not handle it....but, those are questions that you can ask him when you
> have your consultation. If it were me, I would address these issues with
> the doctors that are to be involved in your case and speak with some of
> their patients. I think individuals on this list can provide you with
> the names of people that have gone through the procedure....some of them
> very severe.
>
> God Bless You,
>
> Karla N.
>
>> ----- Original Message -----
> From: LNewman@milbank.com <mailto:LNewman@milbank.com>
> To: Multiple recipients of list ADHESIONS
> <mailto:adhesions@forum.obgyn.net>
> Sent: Monday, April 24, 2000 9:18 AM
> Subject: RE: Adhesions & post- Laparoscopic complications
>
> Are you saying that the more extensive the adhesions, the worst
> chance for the patient's survival or injury? I need to know that because
> I am planning to see a "professional" that is the pioneer of a procedure
> that will almost surely end the suffering of our people. I have been
> told on numerous occasions, after surgery, that I should NEVER have
> surgery again, unless it is life-threatening because my abdomen is like
> cement and very sticky. I need to have a response from you soon
> regarding this because I am planning to call and schedule a consultation.
>
> -----Original Message-----
> From: anonymous@obgyn.net [SMTP:anonymous@obgyn.net]
> Sent: Sunday, April 23, 2000 7:12 PM
> To: Multiple recipients of list ADHESIONS
> Subject: Adhesions & post- Laparoscopic complications
>
> 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 out...it 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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