Treatment of Pelvic Adhesions (Adhesiolysis & Temporary Ovarian Suspension)

Mr. Trehan treats all types of adhesions (including severe bowel adhesions and ‘frozen’ pelvises), no matter how complicated and severe the pelvic pathology by laparoscopic (keyhole) surgery; laparotomy (open surgery) would make the adhesions worse and provide little, if any pain relief and potentially worsen the symptoms.

Adhesions are abnormal bands of scar tissue which joins two or more internal surfaces together. They most commonly form during the healing process following prior pelvic surgery, although other risk factors for pelvic adhesions include a history of pelvic inflammatory disease, perforated appendix, endometriosis, and inflammatory bowel diseases. They can cause pelvic pain and infertility (both by interfering with egg transport and increasing the risk of ectopic pregnancies in which the fetus implants at an abnormal site).

Adhesiolysis is the process of cutting and removing these adhesions and thereby restoring normal pelvic anatomy, usually resulting in a restoration of fertility and a reduction in pain. Mr. Trehan performs adhesiolysis of even the most complicated pelvic pathologies (such as bowel adhesions and ‘frozen’ pelvises) via keyhole surgery.

The ovaries are the most common organs to form adhesions in the pelvis. Following ovarian adhesiolysis (or indeed any pelvic surgery), ovarian adhesions are extremely susceptible to reforming, resulting in a recurrence of ovarian adhesion related symptoms. In order to prevent the formation of these ovarian adhesions, Mr. Trehan pioneered a technique known as Temporary Ovarian Suspension. In this technique, the ovaries are suspended to the anterior abdominal wall during surgery using stitches. This prevents adhesion formation whilst the pelvis heals. These stitches which are visible on the stomach are then cut around 5-7 days later (simply using scissors by your GP). When the stitches are cut, the ovary falls back into its normal place and ovarian adhesions are now unlikely to reform.

Mr. Trehan was the first to practice and publish this technique. The peer-reviewed journal paper published on this technique can be viewed below:

Temporary Ovarian Suspension

Mr. Trehan also presented this technique at numerous international conferences. One of the videos he presented can be seen below:

Mr. Trehan performs all benign gynaecological procedures, including adhesiolysis and temporary ovarian suspension via laparoscopic (keyhole) surgery as it is associated with less post-operative pain and complications, a quicker recovery and a far superior cosmetic appearance when compared to laparotomy (open surgery). In particular, adhesion reformation and hence symptom recurrence is much more likely if the operation is performed via open surgery. Mr. Trehan’s patients can be confident that their operation will be completed by keyhole means as Mr. Trehan’s conversion to laparotomy rate is amongst the lowest in the medical literature, as are his major complication rates, reoperation rates and readmission rates. Further, over 90% of Mr Trehan’s patients are able to leave the hospital after just an overnight stay in hospital.