What is adhesions surgery?

Adhesions are scar tissue. They form between tissues or organs and cause them to stick together. Sometimes they can cause the bowel to get blocked (bowel obstruction). Surgery breaks up and removes this scar tissue.

The most common cause of adhesions in the belly or pelvis is previous surgery in that area.

You will be asleep during the surgery. You may have a nasogastric (NG) tube during the surgery. This goes through your nose and down into your stomach. The tube removes fluids and gas. This helps relieve pain and pressure.

There are two ways to do the surgery. You may have open surgery. This means the doctor makes a cut (incision) in your belly. Or you may have laparoscopic surgery. To do this type of surgery, the doctor puts a lighted tube and other surgical tools through small incisions in your belly. The tube is called a scope. It lets your doctor see your organs to do the surgery. In either surgery, the incisions leave scars that fade with time.

During the surgery, the doctor will look for adhesions. The doctor will also check your bowel to find places where it may be narrowed or blocked. Damaged sections of the bowel may be removed. The doctor will then put the healthy sections back together. In some cases, the doctor makes an opening in the skin on the belly and connects the bowel to that opening. This is called a colostomy or ileostomy. The opening in the skin is called a stoma.

If you only have adhesions removed, you may stay in the hospital for a few days. You may be able to go back to your normal routine in a few weeks.

If the doctor had to reconnect sections of your bowel, you may stay in the hospital for up to a week. You may be able to go back to your normal routine in 2 to 4 weeks.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as biking, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
• Ask your doctor when you can drive again.
• You will probably need to take a few weeks off from work. It depends on the type of work you do and how you feel.
• You may shower 24 to 48 hours after surgery, if your doctor says it is okay. Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when it is okay for you to have sex.

Diet

• You may not have much appetite after the surgery. But try to eat healthy foods. Your doctor will tell you about any foods you should not eat.
• Eat a low-fiber diet for several weeks after surgery. Eat many small meals throughout the day. Add high-fiber foods a little at a time.
• Eat yogurt. It puts good bacteria into your colon and may help prevent diarrhea.
• You may need to take vitamins that contain sodium and potassium. Your doctor will tell you whether you should take any vitamins or supplements.
• Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids until you feel better. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If your doctor recommends or gives you a stool softener for constipation, take it as directed.

Incision care

• If you have strips of tape on the cut (incision) the doctor made, leave the tape on until it falls off. Or follow your doctor's instructions for removing the tape.
• Gently wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing.
• Change the bandage every day or if it gets wet or dirty.
• Keep the area clean and dry.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

If you have adhesions that partly or completely block the bowel (bowel obstruction), you may need surgery right away. You may not have time to prepare.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

You have had surgery to remove adhesions. Adhesions are scar tissue that forms between two structures or organs inside the body that aren't normally connected to each other. You may also have had part of your small or large intestine taken out.

You're likely to feel weak and tired, and you may feel sick to your stomach. It's common to have some pain in your belly and around your incision. The pain should steadily get better over the next few weeks. You may be able to return to normal activities after 2 to 4 weeks. Your bowel movements may not be regular for several weeks. And you may have some blood in your stool.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no surgical site errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery usually takes 1 to 2 hours, but it can take longer.