I have a patient who has acute appendicitis and Acute cholecystitis at the same time. Both diseases need to be operated on fast. The question lies on what incision to make. We always consider the patient's preference aesthetically but we also have to bear in mind the surgical technicality Acute cholecystitis incision is made under the ribs while the Appendectomy is made near the hips. There is another incision which encompasses both of them and that is making an incision in the middle of the abdomen running from the upper portion to the portion below the umbilicus. But this is so ugly most patients will not agree to it.
In cases like these, surgeons do not follow a protocol nor can we find it in medical books. We follow our experience as wells as intuition and foremost what is best for the patient. Truly, medical science is an art.
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