A patient from US for adhesiolysis which had 23 previous surgeries, the last last one was a hernia repair with mesh.

New adhesions formed around the mesh (pic 1) and especially around the metall screws (foreign bodies, pic 2 and 3).

The liver surface was involved in this adhesions as well (pic 4), so it's very difficult to take adhesions down on the liver as it's

bleeding alot. The last picture (pic 5) show the end result: the adhesions are down, the metall screws can't be taken out as they

hold the hernia repair. I have tried some new techniques: some of the screws I covered with omentum to avoid adhesion

reformation to the screws.

 
This is the second case where we have found hernia repair mesh being responsible for adhesions. This is a dilemma,

but we need to educate surgeons to take other materials than metall screws for fixing the mesh, I would prefere to do it with

sutures, but it takes more time and you need to be an experienced laparoscopic surgeon. Most of the surgeons rush and drive in

what is the quickest in their hands, they don't care so much about adhesions.

Image 1 

Image 2 

Image 3 

Image 4 

Image 5 

 

 
In the second look laparoscopy we can see a good result: no adhesions around the mesh area or to the metals screws,

which are covered with fat.

Jaimie was all the week painfree and had wonderfull days. 
As she came here 9 days ago, she couldn't walk straight because of pain…

The new technique for covering the screws with omentum to avoid adhesion reformation to the screws, worked.