Hi Lizabeth22, The DIEP flap surgery dissects blood vessels that are between the anterior and posterior rectus sheaths, behind the rectus muscle but always outside of the abdominal cavity. Although it can happen in the rare occasion of prior surgery and scarring, the DIEP flap surgery generally does not enter the abdominal cavity. Adhesions form when scar tissue links loops of bowel together, and this can occur after an intra-abdominal operation. As the DIEP flap surgery does not enter the abdominal cavity, it should not cause adhesions. Hope this helps. Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington