Laparoscopic adhesiolysis for chronic abdominal pain: An objective assessment

Background and Purpose: Postoperative adhesions frequently occur and can ac count for various symptoms, including chronic abdominal pain. Conventional adhesiolysis by laparotomy results in an unacceptably high rate of recurren ce. A minimally invasive procedure (laparoscopic adhesiolysis) might improv e the outcome by inflicting less surgical trauma, but well-documented repor ts focused on laparoscopic adhesiolysis for chronic abdominal pain are lack ing. Patients and Methods: Twelve consecutive patients with chronic abdominal pa in caused by adhesions who were treated by laparoscopic adhesiolysis were a ssessed preoperatively and during a 1-year follow-up period applying valida ted 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 exp erienced a lasting improvement in quality of life, and five patients had mo re or less stable complaints. Five patients required laparotomy within a ye ar after laparoscopic adhesiolysis, Conclusions: Laparoscopic adhesiolysis has yet not passed the stage of clin ical trial and requires objective evaluation, including detailed informatio n on recurrence and de novo adhesions in correlation with clinical outcome.