The tissue reaction to any injury is known as inflammation. Depending on the type of tissue involved and the amount of damage, the tissue may be restored to normal or scar tissue may form. Tissue injury is generally the result of surgery, infection, haemorrhage (heavy internal bleeding) or trauma.
An adhesion is a thin or thick band of scar tissue that joins two or more internal body surfaces together, hence covering adjacent organs and cavities. Most adhesions are only diagnosed at the time of surgery. Adhesions that involve the uterus, ovaries, fallopian tubes, bowel and/or bladder can form and can lead to chronic pelvic pain, infertility, pain during intercourse (deep dyspareunia) and increased the risk of ectopic pregnancy.
Adhesiolysis involves cutting and releasing the adhesions in order to restore the normal anatomy of the involved organs. Treatment of adhesions can be carried out either by laparoscopy (keyhole surgery) or laparotomy (making a cut in the abdomen). Laparoscopy with gentle tissue traction, the use of non traumatic instruments and hydro-dissection (separation of the tissue using sterile water) is preferred as it appears to be associated with a lower rate of adhesions reformation. At the end of the operation, barriers can be inserted to prevent the healing tissue from sticking together with scar tissue. Barriers are like thin sheets of paper, which are gradually absorbed by the inside tissues.
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