Re: Adhesion-Reduction Surgical Techniques...devised by Harry Reich, MD

From: Sally Grigg (LostCst@mcn.org)
Sat Jan 4 18:53:32 2003


At Sat, 4 Jan 2003, Helen Dynda wrote: >
>[ Note: As of April 1999, Beverly Doucette no longer suffers from adhesion-related pain - following her successful adhesiolysis - with Harry Reich, MD as her surgeon. Bev has provided the following information with the hope that others will be able to benefit from the surgical techniques Dr. Reich has devised to reduce adhesion-formation following surgery.]
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>~ ~ ~ ~
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>X> Adhesion-Reduction Surgical Techniques...devised by Harry Reich, MD -- Dr. Reich used these techniques when he performed Bev's successful surgery in April 1999. Beverly continues to be painerly Doucette
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>Dr. Reich's theory regarding non-reforming adhesions is: "The solution to pollution is dilution!" And he stands by that phrase yet today. This procedure is done through a minimally invasive route. One small incision in the navel for camera, two 1" to 2" incisions on each side of the lower abdomen for instrument use. Dr. Reich is the only ambidextrious surgeon in the United States - and that is a plus for adhesion sufferers!
>He does a diagnostic look-around upon entering the cavity - looking for any invasive pathology besides adhesions. He evaluates the situation and then determines his plan for treatment. In the event that there are dense adhesions, he proceeds to dissect (separate) them. This is not an easy process and is very involved.
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>I can understand why most doctors do NOT want to challenge themselves by doing a lysis, which is dangerous and tedious - as the doctor is working right up against and around the intestines, etc.
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>Based on Dr. Reich's vast experience with laparoscopic surgeries, he has developed a technique like no other surgeon in the world! That is why he has the reputation as being the best laparoscopic surgeon in the world!
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>It was the clean-up at the end of his surgery that impressed me the most - and was also the reason that I chose to go to him and have this done! He cleans out almost EVERY piece of clotted blood that is in, around, under, and virtually all over in the abdominal cavity following the surgery! He believes it is this residual clotted blood - that the anti-bodies in an adhesion-former's system respond to as "foreign" - by creating an adhesion over it to protect the internal organs! Now, this is exactly how our body's defense system works!
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>Think about your getting a sliver (externally, of course). What does our body's defense system do to that foreign body? It sends out the leukocytes and creates an "infection" to get rid of it, right? Internally, one of two types of defense systems kick in when there is a problem:
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>1.) If our appendix ruptures, we get peritonitis (an internal infection - like pus or white blood cells that spill into the abdominal/pelvic cavity). The white cells are responding to an inflammation in the appendix - and build up and burst; but it WAS a defense mechanism as well. Peritonitis can kill us; because the body has no way to rid itself of that infectious drainage - and it infects the surrounding internal organs as well. In defense our body sends the leukocytes (white cells) to the area of "infectious drainage."
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>2.) Because there is an active infectious foreign body in the abdominal cavity, our body will attempt to "CONTAIN" that poison to protect the other internal organs from damage! These white cells form a material called "fibrin". Fibrin is the sticky stuff in the blood. The fibrin starts to cover the infectious material and then you have what is called an "ADHESION!" Now, adhesion means "to stick together." In the abdominal cavity - filled with lots of organs in very close proximity to one another - what do you think will happen? Abdominal organs will become attached to one another - everywhere that the infectious drainage has touched!
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>Let's look at that same reaction now - using the clotted residual blood following your internal surgery. Blood is found throughout the cavity from any area of surgery or ischemia (areas scraped or cut - causing an area that bleeds). In the cavity this blood dries very fast - VERY FAST!
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>Now, 99.9% of surgeons DO NOT clean up the residual blood clots - thus leaving the residual blood clots in, around and under your internal organs. Your body recognizes this blood as a foreign body and sends out the leukocytes - thus forming adhesions wherever these clots of blood are. Because fibrin is sticky, SOME of these organs become attached to the peritoneum (the innermost tissue of the abdominal wall). It is the peristalsis of the intestines that causes a pulling and tugging on the peritoneum. It is the adhesional attachment(s) of the bowel to the peritoneum that causes the inflammation that causes PAIN - and eventually a decrease in our physical mobility. Other organ to organ attachments, if any, don't cause pain; but these other organ to organ attachments can cause:
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>1.) Bowel obstructions
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>2.) Painfull and difficult bowel movements
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>3.) If some adhesions attach the bowel to the vaginal wall, these adhesional attachments can cause painful intercourse (dyspareunia) as well.
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>Dr. Reich uses a procedure called "aqua" surgery. He is constantly flushing the cavity with ringers lactate (a type of fluid that is compatible to the human body - like saline); and when he finds fibrin strings, he removes them bit by bit - a wonderful clean-up job (on my video). If someone would've told me he could clean up the abdominal/pelvic cavity as good as he did - and I had NOT seen him do that - I wouldn't believe them!
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>His theory is that if the cavity is cleaned of the clotted blood, the body's defense system will have less to react to - thus reducing and possibly stopping the reformation of PAINFUL and destructive adhesions. He also leaves 3-4 liters of ringers lactate in the abdomen following a surgery - to enable the body organs to float and to prevent them from sticking to one another. It takes about 48 hours for the ringers lactate to dissipate out of the body...causing "many trips" to the bathroom.
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>Love, Bev

--
Hello, I hope I'm not causing controversy here, it is
not my intent. I also had surgery with Dr. Reich and
felt adhesions within one week. I think his methods are
great, but they still use carbon dioxide and of course
spray gel had not been invented yet. I tried to get
statistics on his success rate, ie no adhesions after
surgery, but he didn't keep them. So I took a survey.
I know its not scientific, because it was only those
people on this board, but the results were not good
overall. Dr. Reich is an honest and good man. He is
currently scheduled to operate with Dr. Kruschinski
in January in Germany where the "no carbon dioxide"
and the spray gel are current practice. So I send both
doctors my good wishes as they try to cure us all from
those horrible adhesions.

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