The first effects from the surgery, considered as the fundamental issue is to cause disease by surgery because it is an action that affects directly to our body and is disrupting the body which may cause subsequent effects.
The first effect of surgery that is the fundamental problem is caused by the disease. Because the surgery is an act that directly affect the body and interferes with the body, which can cause subsequent impacts.
The effect of surgery is the first fundamental problem is to cause disease. Due to the surgical actions that directly affect the body and to disturb the body, which may cause the consequences.