Surgery
The complication no one talks about
Up to 90% of patients develop adhesions after abdominal surgery, yet the public’s understanding of this challenging problem remains poor. Dr. Natalia Peres Martinez highlights an education gap in healthcare – one that creates missed opportunities for patient awareness, shared decision-making and proactive reduction strategies.
Every year, millions of patients undergo surgery expecting that the procedure itself will be the primary focus of their healthcare journey. Most pre-operative conversations understandably centre on the immediate reason for surgery, the recovery timelines, pain management and expected outcomes. Yet one of the most common post-operative complications remains significantly under-discussed with patients: surgical adhesions.1 For many healthcare providers, adhesions
are a familiar clinical reality. For many patients, however, the term is completely unknown until complications arise months or even years after surgery. This disconnect represents a broader education gap in healthcare, one that creates missed opportunities for patient awareness, shared decision-making and proactive reduction strategies.
As healthcare systems increasingly prioritise patient-centred care, transparency and long- terms outcomes, improving education around adhesion reduction should become a more consistent part of the surgical conversation.
Understanding the hidden burden of adhesions Adhesions are bands of internal scar tissue that can form as part of the body’s natural healing response after surgery. They develop when tissues or organs that are normally separate become joined together during healing. While adhesions can occur after many types of procedures, they are especially common following abdominal and pelvic surgeries. What makes adhesions particularly
challenging is that they are often invisible to patients until complications develop. Some
adhesions remain asymptomatic, while others can lead to chronic pain, infertility, bowel obstruction, difficult re-operations and additional hospitalisations.2 The presence of adhesions is substantial.
Up to 90% of patients develop adhesions after abdominal surgery, particularly laparotomy.3 While minimally invasive techniques have reduced tissue trauma in many cases, they have not eliminated adhesion formation altogether. What makes adhesions particularly
challenging is not only their frequency, but their persistence. Unlike complications such as infection or bleeding, which typically arise in the immediate post-operative period, adhesion- related issues often develop over time.4
A
patient may recover successfully from surgery only to experience issues connected to post- operative adhesions.
Complications and hospital admissions commonly occur in the five-year period after
The presence of adhesions is substantial. Up to 90% of patients develop adhesions after abdominal surgery, particularly laparotomy.
both open and laparoscopic surgery.5
These
presentations may take many forms from acute bowel obstruction requiring urgent intervention, to chronic, low-grade symptoms that prompt repeated investigations and referrals. For health systems, this represents a hidden burden: complications that are linked to surgery yet occur long after routine follow-up has ended.6 Despite this, adhesions are often framed as
a largely unavoidable consequence of surgery, something to be accepted rather than actively addressed. This framing risks minimising their long-term impact and discourages proactive discussion with patients. When complications arise years later, the connection to surgery may not be immediately recognised, contributing to delays in diagnosis and management. Understanding the true scale of adhesions is the first step in reframing them not as a rare or peripheral issue, but as a common outcome with meaningful implications for patients and services alike.
The patient education gap In today’s healthcare environment, patients increasingly expect to be active participants
July 2026 I
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