adhesiolysis

Adhesiolysis, also called adhesion release, is a surgical procedure to cut, remove, or separate adhesions—bands of scar tissue that form between surfaces within the body, commonly peritoneal surfaces after surgery, infection, inflammation, or endometriosis. Adhesions can restrict movement of organs, cause pain, or lead to mechanical obstruction; adhesiolysis aims to restore normal tissue planes and function.

Indications include symptomatic abdominal or pelvic adhesions causing chronic pain or infertility, intestinal or ureteral obstruction from adhesions, or adhesion-related complications after gynecologic or abdominal surgery.

Techniques include open (laparotomy) or minimally invasive (laparoscopic) approaches. Dissection is performed by blunt, sharp, or hydrodissection methods, sometimes aided by energy devices. Care is taken to avoid injury to adherent viscera and vessels. In pelvic surgery, meticulous release of adhesions around reproductive organs may be performed. Use of adhesion barriers (such as hyaluronic acid-carboxymethylcellulose or collagen-based products) during closure may reduce recurrence in some settings, though evidence varies.

Outcomes are variable. Some patients experience relief of pain or obstruction and improved fertility, but adhesions may recur, and repeat surgery is sometimes necessary. Complications can include unintended organ injury, bleeding, infection, bowel perforation, or postoperative ileus.

Prevention focuses on minimizing peritoneal trauma during the initial surgery and, when appropriate, applying adhesion barriers, careful hemostasis, gentle tissue handling, and early mobilization to reduce recurrence risk.