The reaction of endothelial tissue to surgical trauma, by the more or less constant formation of abnormal adhesions, indicates that nearly all surgery within the peritoneal cavity is nothing more than an exchange of one abnormality for another. The ratio of this exchange determines directly the success of the operation. And too often, owing to this endothelial susceptibility, surgery within many peritoneal cavities results in nothing more than a traumatic truce.
That crippling of the parietal and omental adhesions follows the majority of operations for removing the appendix can be demonstrated at later operations during an exploration of the ileocecal segment. These adhesions, which appear rather conspicuous for the accorded simplicity of the operation, are often of little practical significance; but in a sufficient number of instances they are very undesirable. To them can often be attributed localized pain and tenderness, the onset of a previously absent sluggish cecum, and
ROEDER CA. APPENDECTOMY: A STUDY IN TECHNIC. Arch Surg. 1925;11(1):18–24. doi:10.1001/archsurg.1925.01120130025002
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