Is it possible for adhesions to form after diep gap surgery?

Question

I had diep gap surgery 10 years ago. For the last two years I have had chronic stomach cramps and diarrhoea. This happens regularly.

Christopher Pannucci, MD, MS · Answer

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

Ali Sadeghi, MD, FACS · Answer

Thanks for your question.  Neither the DIEP or GAP free flaps used for breast reconstruction should enter the abdominal cavity during harvest of these flaps.  It's unlikely that your symptoms are related to the breast reconstruction surgery.

Wojciech Dec, MD · Answer

Adhesions can form after abdominal surgery when intestines heal to themselves or the abdominal wall.  In a DIEP flap, however, the surgeon operates outside of the abdominal cavity so it would be unlikely for the intestines to have developed a predisposition to form adhesions.Rarely it is possible to develop a hernia after a DIEP flap procedure if the abdominal wall segments do not heal properly. Typically hernias present within a year or two of surgery, so at ten years this would be little unusual. A hernia may present with a range of symptoms including the type you describe, but it is possible your GI symptoms are an unrelated issue.A good place to start would be to bring this up with your plastic surgeon who performed the breast reconstruction or a GI specialist.Dr. Dec

Is it possible for adhesions to form after diep gap surgery?

Answers (3)

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