Adhesions: Before Your Surgery

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What is the surgery for adhesions?

Adhesions on small intestine

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 so he or she can do the surgery. In either surgery, the incisions leave scars that fade with time.

During the surgery, the doctor will look for adhesions. He or she will also check your bowel to find places where it may be narrowed or blocked. The doctor may also remove damaged sections of the bowel. He or she 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 1 to 2 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.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

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

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

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

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no 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.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to http://www.healthwise.net/ed

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