44180 Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)

Name of the Procedure:

Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)

Summary

Laparoscopy for enterolysis is a minimally invasive surgical technique used to remove or separate adhesions (scar tissue) in the intestines. These adhesions can cause pain or bowel obstruction.

Purpose

The procedure addresses intestinal adhesions that can cause chronic abdominal pain, bloating, and intestinal blockages. The goal is to free the intestines from restrictive scar tissue to restore normal bowel function and alleviate pain.

Indications

• Chronic abdominal pain due to adhesions.
• Bowel obstruction or recurrent episodes of partial obstruction.
• Diagnostic imaging showing adhesions.
• Failure of conservative treatments (pain management and diet modification).

Preparation

• Fasting from midnight before the surgery.
• Possible adjustment of current medications as per physician instructions.
• Preoperative assessment may include blood tests, imaging studies (like CT scan or MRI), and a physical examination.

Procedure Description

1. Anesthesia: The patient is placed under general anesthesia.
2. Incision: Small incisions are made in the abdomen.
3. Insertion of Laparoscope: A thin tube with a camera (laparoscope) is inserted through one of the incisions, allowing the surgeon to see inside the abdomen.
4. Insertion of Surgical Instruments: Other small tools are inserted through additional incisions.
5. Dissection: The surgeon carefully cuts and separates the adhesions from the intestines.
6. Closure: The instruments are removed, and the incisions are closed with stitches or surgical glue.

Duration

The procedure typically takes 1 to 3 hours, depending on the extent of the adhesions.

Setting

The procedure is performed in a hospital surgical suite or an outpatient surgical center.

Personnel

• Surgeon specialized in laparoscopy.
• Surgical nurses.
• Anesthesiologist.
• Operating room technician.

Risks and Complications

• Infection at the incision sites.
• Bleeding.
• Injury to surrounding organs (intestines, bladder).
• Adverse reactions to anesthesia.
• Risk of adhesion recurrence.

Benefits

• Relief of chronic abdominal pain.
• Improvement in bowel function.
• Reduction in episodes of bowel obstruction.
• Smaller incisions leading to quicker recovery compared to open surgery.

Recovery

• Patients can usually go home the same day or the next day.
• Post-operative instructions include avoiding strenuous activity for a few weeks.
• Pain management may involve prescribed medications.
• Follow-up appointment is typically scheduled within a few weeks to check healing.
• Full recovery usually takes 2-4 weeks.

Alternatives

• Conservative management with pain medications and dietary changes.
• Open surgery for severe cases with extensive adhesions.
• Pros of laparoscopy include less pain and faster recovery; cons might be the potential need for conversion to open surgery if complications arise.

Patient Experience

• During the procedure, the patient will be unconscious due to general anesthesia.
• Post-operatively, mild to moderate pain is expected at the incision sites, managed with medications.
• Possible discomfort from the gas used to inflate the abdomen, which dissipates within a few days.
• Instructions on managing pain, mobility, and diet will be provided to ensure a smooth recovery.