Laparoscopic Adhesiolysis for Chronic Abdominal Pain: An Objective Assessment

Abstract

Background and Purpose: Postoperative adhesions frequently occur and can account for various symptoms, including chronic abdominal pain. Conventional adhesiolysis by laparotomy results in an unacceptably high rate of recurrence. A minimally invasive procedure (laparoscopic adhesiolysis) might improve the outcome by inflicting less surgical trauma, but well-documented reports focused on laparoscopic adhesiolysis for chronic abdominal pain are lacking. Patients and Methods: Twelve consecutive patients with chronic abdominal pain caused by adhesions who were treated by laparoscopic adhesiolysis were assessed preoperatively and during a 1-year follow-up period applying validated scoring systems: McGill and SLC-90 tests to evaluate personalities and MOS SF-36 and GIQLI questionnaires for the quality of life assessments. Results: No psychological influences were identified. Only two patients experienced a lasting improvement in quality of life, and five patients had more or less stable complaints. Five patients required laparotomy within a year after laparoscopic adhesiolysis. Conclusions: Laparoscopic adhesiolysis has yet not passed the stage of clinical trial and requires objective evaluation, including detailed information on recurrence and de novo adhesions in correlation with clinical outcome.