You may find it hard to believe; but it took more than 27 years for me to learn the true cause of the debilitating pain that had dominated my life following a laparotomy in February 1970.
It was my constant search for information that eventually led me to an endometriosis specialist, who listened to me, believed me and then told me a diagnostic laparoscopy is the only way to determine the cause of my abdominopelvic pain.
August 1, 1997 I was scheduled to have a diagnostic laparoscopy; but because of massive adhesions the surgeon had to perform an adhesiolysis first. Adhesions had attached my omentum to my abdominal wall completely covering a 7 inch by 4 inch area - and tightly adhering my abdominal wall and omentum together.
Whether you have endometriosis or adhesions (or both), I urge you to learn as much as you can about adhesions - and any other medical condition you may have. Adhesion related disorder (ARD) is so poorly understood by the medical profession; and there are far too many doctors who don't believe - or won't admit - that adhesions can cause pain!! With the knowledge you gain, you will be able to recognize if your doctor has the same understanding about ARD as you do. If he/she doesn't, then it's time to look for a doctor who does!!
ARD is not recognized by the medical profession as being either a disease or a disorder!! As a result, surgeons are very poorly reimbursed - by the insurance industry and government insurance (Medicaid and Medicare) - for the amount of time it takes a very skilled laparoscopic surgeon to complete a lengthy, very difficult and risky adhesiolysis procedure. Consequently, very few surgeons are willing to perform adhesiolysis procedures!! However, if the patient is experiencing a complete bowel obstruction, this is an emergency situation - and the surgeon has no choice but to operate!!
You will learn that there are only two adhesion barriers that are currently available: Interceed and Seprafilm. These adhesion barriers have been approved by the FDA for open abdominal procedures (laparotomy) only!!! Only an informed doctor will know adhesion barriers are available. A doctor, who is not aware of adhesion barriers, will not have the skill and experience needed to apply these adhesion barriers correctly.
Unfortunately, none of these adhesion barriers are 100% effective. Each barrier has its own problems. Seprafilm is brittle and is difficult for the surgeon to use. When moistened, Seprafilm becomes sticky and very difficult for the surgeon to apply. If any amount of blood remain in the abdominopelvic cavity, Interceed will not be effective. Since both of these adhesion barriers are NOT consistently effective, many of the best surgeons do NOT apply an adhesion barrier at the conclusion of surgery.
In November 2001 the Confluent SprayGel adhesion barrier was approved by the European Union for use in laparoscopic surgical procedures in Europe. SprayGel clinical trials began in June 2002 at several locations in the United States. It may take a couple of years before Confluent Surgical will be ready to present the results of the SprayGel clinical trials to the FDA for their approval. Currently, SprayGel is being used in Australia, Europe and the United Kingdom - with encouraging results!!
The purpose of an adhesion barrier is to prevent the formation of adhesions. Adhesions are known to form within three hours following a surgical procedure. This completely natural and normal process is how the human body tries to heal and protect itself following a surgical procedure!! Adhesions will continue forming for up to 7 days after a surgical procedure!! After 7 days - and as they mature - adhesions gradually begin to shrink and become more dense.
If adhesions have attached any of the internal organs to the peritoneum, this will definitely cause pain!! For example: If the adhesions have attached the bowel to the peritoneum, the peristalsis of the bowel will pull or cause a twisting action on the peritoneum. The peritoneum has a rich supply of nerve endings; and the continual peristalsis action of the bowel on the peritoneum will cause these nerves to become irritated and inflamed. This constant irritation and inflammation on the peritoneum WILL cause pain!!
The first step in seeking help for adhesions related disorder (ARD) is for you to learn as much as you can about ARD and how ARD is affects a person - physically, emotionally, psychologically and spiritually.