Adhesion Related Disorder Treatment

Doctors at Adhesiologicum™ Germany always try to avoid the condition of an intestinal blockage at patients with adhesions.

Why ? Because they have the tools that work (gasless Lift-Laparoscopy and sufficient Adhesion barriers) to succesfuly treat adhesions AND prevent adhesion reformation. Avoiding Carbon dioxide gas insuflation as it happens during gas laparoscopy prevents mesothelial hypoxia (co-factor in adhesion formation!) as it occurs during CO2 pneumoperitoneum (Koninckx  et al., 2010).

The surgeons at Adhesiologicum™ Germany are highly skilled as they perform adhesiolysis procedures on a daily basis on patients with severe and recurrent adhesions since 15 years. An adhesiolysis procedure should only be performed by an experienced and well trained surgeon!

They perform adhesiolysis on cases that no one else wants to treat to PREVENT those horrible emergency condition. All other surgeons do not surgery until there is an obstruction!

Patients with adhesions, but also all other patients might look at this:

Your disease is so serious that it bothers you in your every day life?
Maybe your doctor and your family doesn’t take it serious anymore?
Maybe your doctor is saying “no way you can still have adhesions…”?

The doctors at Adhesiologicum™ Germany consider your pain as real…

They believe that you are suffering from pain…
They know that your pain is not in your head…
They consider your disease seriously…
They are specialized in advanced laparoscopic surgery…
They will try to do the best and to help you at surgical, medical and mental levels…
They include the recent modern technologies to achieve the best results for the patients…

In one of Dr. Kruschinski’s consultation hours there was a patient with the typical story of a patient with an adhesions disease:

Many surgeries, anyone believes her pain, no surgeons would touch her, is about to being send to a psychiatric department, as the doctors ignore her pain…

She presented this photo (on the left) to him to show how she thinks and feels, her abdomen must look like…

Please look at this images and let it affect on you…

We think, it is a wonderful abstract image of an abdomen full of adhesions (right), isn’t it ?

 

Carbon dioxide customarily used to insufflate the abdomen during laparoscopy converts the entire peritoneum into an acidotic environment. This results in oxygen being withdrawn from the tissue. Lack of oxygen cause cell-death with formation of global wound surfaces in the peritoneum and abdominal organs. The potential of forming adhesions after a carbon dioxide laparoscopy was studied in the experimental work of Koninckx et al. to show that carbon dioxide is a co-factor in adhesion formation.

By using gasless lift- laparoscopy, we avoid insufflation of carbon dioxide, which has been shown by the aforementioned studies to be a co-factor in adhesion formation.

Avoiding Carbon dioxide gas insuflation as it happens during gas laparoscopy prevents mesothelial hypoxia (co-factor in adhesion formation!) as it occurs during CO2 pneumoperitoneum (Koninckx  et al., 2010).

To cut adhesions we use the GlaDiaThOR bipolar scissors designed by Dr. Kruschinski to perform the adhesiolysis procedure without bleeding. By these scissor the vessels and capillaries are coagulated while cutting which not only decreases hemorrhage but also the procedure duration. By excluding / reducing bleeding less adhesion reformation occur.

Wound surfaces adhere to each other and form adhesions. Abdominal and pelvic adhesions can cause problems such as pain, adhesions of uterine tubes (infertility) or of other organs (intestines / ovaries / uterus).

After adhesiolysis the gel substance (SprayShield™) is sprayed on the wound surfaces, where it remains in place for some days after surgery. Since adhesions are formed within 7 days of surgery, the barrier shield prevents formation of adhesions. After this period, SprayShield™ is broken down and absorbed by the peritoneum to be cleared from the body via the kidneys.

Dr. Daniel Kruschinski is one of the very few surgeons in the world, who performs a second look laparoscopy (SLL) about seven days after the initial surgical procedure. In Dr. Kruschinski’s experience the risk of adhesions resulting in the need for a subsequent surgery is greatly reduced. He has mastered the required advanced microsurgical laparoscopic techniques and has logged thousands of hours in performing very difficult, time-consuming, risky surgical procedures. Repeat surgery for adhesions in these cases is usually less extensive and does not usually involve the same amount of dissection that led to the formation of adhesions in the first place

Adhesions are known to form as soon as three hours after the completion of a surgical procedure – and will continue to form for up to about four days. Please see what happens, if surgeons are not using any adhesions barrier. If adhesions still have formed during this critical time period, they can easily be “swept down” by the surgeon by aqua dissection without bleeding during the second look laparoscopy – and more SprayShield™ can be applied, if needed.

If your surgeon does not perform an early 2nd look procedure, the adhesiolysis might not work!