“Postoperative intra-abdominal adhesions are a major concern in modern surgery. Intestinal obstruction is an important and well known clinical consequence of adhesions, resulting in significant morbidity and mortality rates, and high financial costs. Secondary infertility in women and chronic abdominal and pelvic pain are other, frequently cited, adhesion-related problems. Furthermore, intraabdominal adhesions render reoperation dif®cult and may
increase the complication rate of the intended surgical procedure. Prolonged operating time, unfeasibility of the laparoscopic approach and inadvertent enterotomy are known drawbacks of reoperative abdominal surgery, directly related to adhesions.”

“Underestimating the clinical consequences of inadvertent enterotomy and inability to prevent adhesions effectively are two main reasons why adhesion-related disorders
have rarely been addressed in the past.”

“Approximately one in five patients who were reoperated on suffered one or more inadvertent enterotomies. The 19 per cent prevalence is not a completely accurate reflection of the occurrence of this complication, since patients who had previous abdominal surgery but underwent laparotomy via another incision were excluded from this study. Such
patients are unlikely to have adhesions under the new incision so including them would have lowered the prevalence. However, because fewer adhesions would be expected under a new incision, less emphasis might be placed on a slow, meticulous and trauma-free entrance to the abdomen in comparison to re-entering the abdomen through a previous incision, resulting in an even higher incidence of inadvertent enterotomy.”

Van Der Krabben, A A et al. “Morbidity and mortality of inadvertent enterotomy during adhesiotomy.” The British journal of surgery vol. 87,4 (2000): 467-71.