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Adhesiolysis

Adhesion Treatment - The medical term for adhesion removal surgery is adhesiolysis. Laparoscopic surgery for abdominal adhesions is the most successful and least invasive approach to scar adhesion treatment.   Drs. Miklos & Moore are experts in adhesion removal surgery and perform only laparoscopic surgery for abdominal adhesions.  Several studies have proven that cutting adhesions (lysis or adhesiolysis) often provides pain relief.  

Adhesiolysis video


See Drs Miklos and Moore’s real video footage Adhesive Removal Surgery. Click here to watch video

Adhesion Removal Surgery - Drs. Miklos & Moore Technique

Dr Miklos & Moore always attempt to minimize trauma and bleeding to the patient at the time adhesion removal by doing the following:

  1. Use laparoscopic surgery for abdominal adhesions and pelvic adhesions- many surgeons will still perform a large incision on the belly for adhesion removal.  This is not the preferred approach as the larger the incision the greater chance of adhesion formation.   Doctors Miklos & Moore have not used a large belly incision in more than 8 years to treat a patient for any of their procedures.
  2. Minimize electric energy -   many surgeons will burn every adhesion prior to cutting them.  The reason for burning the adhesion prior to cutting the adhesion is to prevent bleeding.   The problem with burning adhesions is the heat creates thermal damage and the tissue begins to slough ie “rot” over the next few days.  This creates sticky tissue which creates even more adhesions. Drs. Miklos & Moore  use electric energy ie cautery only when it is needed.  So they actually cut the adhesions first and only if the bleeding persists will they use energy to cauterize or stop the bleeding.  Drs. Miklos & Moore estimate they use electrocautery on less than 5% of their adhesions. 
  3. Gentle tissue handling  -  minimizing trauma to the area by handling tissue with the utmost care is crucial to minimizing adhesion formation
  4. Minimize blood loss  -  blood loss comes from traumatized tissue, if one minimizes trauma to the tissue then there will be less blood loss.  Less blood loss means less adhesion formation.
  5. No Powdered gloves -  some surgical gloves actually have a talc type powder on them.  Dr Miklos & Moore make sure their gloves are foreign body free.  Foreign bodies mean more adhesions.
  6. Anti adhesive agents – though not agent has ever been proven to definitively work against preventing adhesions, Dr Miklos & Moore are not against using products such as : Interceed, Spray Gel, Adept etc….  Dr Miklos & Moore allow the patient to make the decision as to whether an anti adhesive agent should be used.

Open Laparoscopy Technique

injecting incision site

Injecting Incision Site – with anesthetic agent prior to the incision reduces the postoperative pain the patient feels

incision

Incision – the incision is made in the inferior border of the belly button


abdominal fascia

Abdominal Fascia – the abdomen fascia is grasped with
two clamps and incised. The fascia is the tissue which holds
the abdominal wall together and along with the abdomen
muscles gives the abdomen strength

suture tags of fascia

Suture Tags of Fascia - sutures are placed on the edges of the fascia so the surgeon can better identify the fascia at the end of the case. Meticulous closure of the fascia helps to prevent hernia formation.


Hasson trocar placement

Hasson trocar placement – this trocar is utilized for placement of the laparoscope ie. Camera scope.

Hasson trocar placement

Accessory port placement – 2-3 other trocars are placed to complete the adhesion treatment surgery. Aka . laparoscopic adhesiolysis


Drs. Miklos and Moore perform laparoscopic adhesiolysis using scissors with minimal electric energy. Minimizing energy, utilizing precise surgical technique with minimal bleeding during the adhesiolysis will prevent further damage and potentially the reformation of more adhesions. Please click the video below to see their technique of laproscopic adhesiolysis with minimal electrical energy used.

Adhesiolysis video


See Drs Miklos and Moore’s real video footage Adhesive Removal Surgery. Click here to watch video




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