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Adhesions increase the risk of abdominal or pelvic surgery

Experts advise surgeons to convert from laparoscopic to open surgery when encountering severe adhesions

Our firm has handled several Texas medical malpractice cases where patients had abdominal or pelvic surgery that went amuck because of a surgeon’s poor handling of adhesions.

Adhesions are connective tissue formations that connect structures that are normally separate and unconnected. They can form because of trauma to the abdomen and pelvis, but more frequently form in the natural process of healing after surgery. Different medical studies have reported the presence of adhesions in between 20–93% of surgical patients.

Surgeons encountering adhesions in the operative field must dissect through them without damaging vital organs, blood vessels, or nerves. This requires extra time and attention because adhesions themselves can become vascularized and innervated over time, meaning that they can have their own blood vessels and nerves.

 One of our clients was left with permanent disabilities and a colostomy bag after an abdominal surgery. Before the planned laparoscopic, or minimally invasive, abdominal surgery, the surgeon told the patient and her family that the whole procedure should take two or three hours.

A laparoscopic surgery, by the way, is a technique where surgeons use small incisions and equipment, including a surgical camera, rather than making a large open incision, as is the case with conventional surgery. In our client’s case, the surgeon encountered extensive adhesions that required about six hours of dissection. 

During the dissection and removal of the adhesions, the surgeon accidentally perforated, or cut a hole, in the patient’s bowel. Based on the limited visibility of the surgical field, the surgeon didn’t notice this. In fact, there was a delay in diagnosis and returned to the operating room to repair the hole, during which interval the patient developed infection, sepsis, and bowel necrosis.  As a result, the surgeon had to cut away most of the patient’s bowel. That’s what left her with permanent disabilities and a colostomy bag.

As part of our careful review of this medical malpractice case, we retained a board-certified general surgeon to review the care at issue. Our expert concluded that the treating surgeon should have converted the laparoscopic surgery to an open procedure once she encountered the extensive abdominal adhesions. This would have allowed the surgeon to have a safer and clearer view of the operative field than what was possible laparoscopically in the context of adhesions.

In another case, a woman went to the hospital to have one of her ovaries removed laparoscopically. This is a procedure called oophorectomy. The gynecological surgeon told the patient before the procedure that it should take about an hour that she’d be discharged home the same day.

When the surgeon took her to the operating room, though, he encountered extensive adhesions. Again, the surgeon decided to continue laparoscopically and perforated her bowel during the surgery.

Like the other case, this poor woman faced months of hospitalization and additional surgeries to save her life. Sadly, these injuries would likely have been avoided if the surgeon had converted from laparoscopic to open surgery.

Our surgery expert also shared his opinion that the standard of care requires careful post-operative monitoring of an abdominal surgery patient whose surgery was complicated by adhesions. It’s not always possible to identify a perforation or accidental injury to a vital structure. With careful nursing and physician follow-up care, though, these complications can be diagnosed and timely treated before they cause permanent injuries and impairments.

If you’ve been seriously injured because of poor surgical or hospital care in Texas, then contact a top-rated, experienced Texas medical malpractice lawyer for a free consultation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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