Description

Adhesions are one of the most challenging postoperative complications that can occur following intra-abdominal surgery. When these adhesions develop after an Intraperitoneal Onlay Mesh (IPOM) hernia repair, they can sometimes lead to small bowel obstruction (SBO) — a serious condition that requires timely and precise surgical management. At World Laparoscopy Hospital (WLH), Gurugram, renowned for its excellence in minimally invasive surgery, such complex cases are handled with world-class expertise and advanced laparoscopic technology. Understanding the Condition After IPOM mesh repair, the mesh is placed inside the abdominal cavity in close contact with the intestines. Despite modern composite meshes designed to minimize adhesions, some patients may still develop fibrotic tissue bands that tether the bowel to the mesh or abdominal wall. Over time, these adhesions can restrict intestinal movement, leading to partial or complete obstruction. Patients often present with symptoms such as abdominal pain, distension, nausea, vomiting, and constipation. In severe cases, this can progress to strangulation of the bowel, making early diagnosis and intervention crucial. Laparoscopic Management at WLH At World Laparoscopy Hospital, surgeons led by Dr. R. K. Mishra, a pioneer in laparoscopic and robotic surgery, perform laparoscopic adhesiolysis with utmost precision and safety. The goal is to release the adhesions, restore bowel continuity, and minimize the risk of recurrence—all through a minimally invasive approach. Step-by-Step Laparoscopic Procedure: Patient Evaluation and Imaging High-resolution CT scan and abdominal X-rays are performed to confirm the diagnosis and identify the level of obstruction. Detailed assessment ensures careful planning before surgery. Port Placement and Access Access is achieved using an open (Hasson) technique to avoid bowel injury in patients with previous surgeries. Ports are placed strategically under vision to ensure optimal working space. Exploration and Adhesiolysis Using fine laparoscopic instruments and advanced energy devices, surgeons carefully separate the adhesions between the bowel loops, omentum, and the mesh. Gentle dissection is key to preventing bowel injury. Assessment of Bowel Viability Once adhesions are released, each segment of the intestine is evaluated for vascularity. Any ischemic segment is resected laparoscopically, if necessary. Mesh Evaluation The previously placed IPOM mesh is inspected. If it shows signs of infection, shrinkage, or erosion into the bowel, it may be partially or completely removed and replaced with a new anti-adhesive mesh if required. Closure and Recovery The procedure is completed with careful hemostasis, lavage, and closure of port sites. Patients are mobilized early to enhance recovery. Why Choose World Laparoscopy Hospital? Expertise of Dr. R. K. Mishra – Over two decades of experience in advanced laparoscopic and robotic surgeries. State-of-the-Art Facilities – Equipped with 4K imaging, high-definition 3D laparoscopy, and robotic surgical systems. Global Training and Research Hub – WLH is not only a center for patient care but also a world leader in laparoscopic training and innovation. Minimally Invasive Excellence – Reduced postoperative pain, shorter hospital stay, faster recovery, and minimal scarring. Outcome and Recovery Most patients undergoing laparoscopic adhesiolysis at WLH experience rapid recovery, early return of bowel function, and significantly reduced postoperative pain compared to open surgery. The minimally invasive approach also lowers the risk of new adhesion formation. Conclusion Laparoscopic surgery for adhesions after IPOM mesh causing small bowel obstruction represents the pinnacle of modern minimally invasive care. At World Laparoscopy Hospital, this procedure is performed with precision, safety, and compassion—restoring health and quality of life for patients from around the globe.