(1) Background: Abdominal adhesions are a common disease appearing after any type of abdominal surgery and may prolong surgical time and cause intestinal obstruction, infertility, or chronic pain. We propose the use of intraperitoneal collagenase to perform chemical adhesiolysis based on the pathophysiology and histology of adhesions. (2) Methods: We generated an adhesion model with intraperitoneal polypropylene meshes. Four months later, we evaluated the efficacy of the treatment in blinded form, i.e., 0.05% collagenase vs. placebo at 37 °C for 20 min. Protocol 1: Ten rats with ten mesh fragments, in which an attempt was made to remove the maximum number of meshes in a 5-min period. Protocol 2: Six rats with four mesh fragments in the sides of the abdominal cavity in which adhesiolysis was performed using a device that measures burst pressure. (3) Results: Protocol 1: 42% efficacy in the collagenase group versus 8% in the control group (p < 0.013). Protocol 2: 188.25 mmHg (SD 69.65) in the collagenase group vs. 325.76 mmHg (SD 50.25) in the control group (p < 0.001). (4) Conclusions: Collagenase allows for the safe and effective chemical adhesiolysis in this experimental model of adhesions.

A 73-year-old woman presented to the emergency department with a painful umbilical nodule that had been enlarging over the past 4 months. In the 2 days before presentation, the patient noted new bloody exudate from the nodule. Physical examination revealed a painful and firm, erythematous umbilical nodule measuring 2 cm in its largest diameter (Panel A) and a palpable pelvic mass. Computed tomography of the abdomen and pelvis showed a heterogeneous pelvic mass measuring 11 cm by 11 cm by 9.5 cm (Panel B, arrow), moderate ascites, peritoneal carcinomatosis, and a nodule measuring 2.4 cm (largest diameter) in the umbilical region (Panel B, arrowhead). Diagnostic laparoscopy and biopsies of the large mass, umbilical nodule, and peritoneal implants were performed, and pathological analysis confirmed the diagnosis of high-grade serous ovarian carcinoma. A Sister Mary Joseph’s nodule is a metastatic umbilical lesion in the umbilicus and is typically associated with gynecologic and gastrointestinal cancers. The patient underwent cytoreductive surgery and received adjuvant chemotherapy.