The injured peritoneum: Consequences of surgery on an organ
2009
__Abstract__
Surgical trauma to the peritoneum is inevitable during abdominal surgery,
whether performed by laparoscopy or laparotomy. Obviously, entering the
abdominal cavity is an essential prerequisite in order to be able to perform
any kind of surgical intervention intra-abdominally. However, among surgeons
there is only little awareness of the consequences of this essential part of an
abdominal procedure.
Postoperative adhesions, responsible for an increased risk of small bowel
obstruction, infertility, chronic abdominal pain and considerable difficulties at
re-operations, are often taken for granted whereas attempts to prevent them
are not being considered. In case of oncological abdominal surgery the traumatised
peritoneum may facilitate outgrowth of spilled tumour cells, inducing peritoneal
carcinomatosis and hence a worsened outcome for the patient. Increasing
the awareness of sequelae of surgical trauma to the peritoneum hopefully
leads to a reduction ofthe amount of peritoneal damage during surgery and a
decrease in postoperative morbidity for the patient.
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