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Anatomical Dissection for Adhesions

  • Ricardo Z. AbdallaEmail author
  • Danniel Frade Said
Chapter
  • 316 Downloads

Abstract

Surgical adhesions are well known in reoperations, but they are found in virgin abdomens as well. They could be strong, well-adapted bridges or loose attachments between very active organs and strand structures. Going into the peritoneal cavity could cause problems for the surgeon even for well-trained professionals. Whether one is choosing open, video, or robotic-assisted surgery, caution in accessing the cavity must be considered. This chapter favors the use of robotic instruments to remove adhesions from the anterior abdominal wall, under inflammatory conditions that give these adhesions the whole variety of presentations. Sometimes they are easy to dissect, but sometimes they are part of the wall with no evident dissection plan, with the scar completely attached to muscles, fascia, or hernia sac.

These different presentations are well evidenced, clearly presented, and better planned to be lysed if our tools can allow us stability, tremor control, detailed visualization, and comfort to work longer in difficult cases as robotic-assisted surgery can do.

Keywords

Adhesions Adhesiolysis Pneumoperitoneum dissection Small bowel obstruction Laparoscopic hernioplasty Robot-assisted adhesiolysis Permanent scar Incarcerated hernia Attachments Reconstruction Entero fistulas Bowel suture 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Digestive Surgery Division, Department of GastroenterologyUniversity of Sao Paulo School of MedicineSão PauloBrazil
  2. 2.Sao Paulo Cancer Institute at University of Sao PauloSão PauloBrazil
  3. 3.Medical School of ABCSanto AndréBrazil

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