WOMENS-HEALTH Messages for June, 1998: Re: Is surgery to remove adhesions justifiable surgery?

Re: Is surgery to remove adhesions justifiable surgery?

From: William D. McIntosh, MD (anonymous@obgyn.net)
Mon, 29 Jun 1998 17:58:04 -0500 (CDT)

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At Mon, 29 Jun 1998, Helen wrote: >
>I had a diagnostic laparotomy 11 months ago which revealed massive
>adhesions between the omentum and the abdominal wall (after a laparotomy
>many years earlier). No adhesion-barrier was used. After surgery, I
>experienced several days of feeling really good and like myself again.
>BUT then I started feeling pain again...which I am sure is the result of
>adhesions reforming. I have seen an internist at the Mayo Clinic, who
>said that he did not feel that this was an adequate surgical reason for
>doing another laparoscopic adhesiolysis. And yet I am in pain
>everyday...all day! My question is, " When adhesions reform after a
>diagnostic laparoscopy has been done, is there any medical reason why a
>person cannot have a repeat laparoscopy to try to eliminate them with
>the use of an adhesion-barrier? I was told that I would have to have
>some other medical problem that required surgery...that surgery could
>not be done for adhesions alone...that this would be unjustified
>surgery. I find this hard to believe since I know that
>adhesion-barriers are available and that second-look laparoscopy is also
>a possibilty. I hope that you will be able to help me make a decision
>as to my next possible step. Or do I just accept the advice of the one
>internist?

With all due respect to our internal medicine collegues (they certainly know more about medicine than your average gynecologist), you would be better off seeking 1 or 2 opinions from a surgical specialist, either general surgeon or gynecologist. After all, these are the ones who actually do that type of surgery, and would therefore have the latest and best information. Adhesion barriers do exist, and they are somewhat effective, but no where near as much as we had hoped. Used improperly, they can even make the adhesions worse.

-- William D. McIntosh, MD

This is not intended to replace consultation and examination by a medical practitioner.

Next message: William D. McIntosh, MD: "Re: Second Opinion re: Infertility Treatment -- Doctors Please Read"
Previous message: CHRIS: "Re: Is surgery to remove adhesions justifiable surgery?"
In reply to: Helen: "Is surgery to remove adhesions justifiable surgery?"
Next in thread: J.Glenn Bradley MD: "Re: Is surgery to remove adhesions justifiable surgery?"

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