Jejunal segment resection with side-to-side anastomosis

Small median laparotomy, depending on the location of the findings in the small intestine above the umbilicus, periumbilical or below the umbilicus.
It should be noted that laparotomies in the lower abdomen leave a cosmetically better result. The skin incision should be started with a length of about 8 cm. Through this, the small intestine can usually be adequately exteriorized and, if necessary, the skin incision can then be extended. As a rule, a left-sided circumincision of the umbilicus, if required, is common.

When an anastomosis is performed, it is advisable to protect the skin edges by folding them over with a foil or a moist abdominal cloth and then to insert a retractor.

The small intestine is eventrated and the finding is located. Whenever possible, the entire small intestine should be inspected, which, provided no adhesions are present, is usually possible through a correspondingly small surgical access.

Subsequently, the resection boundaries are defined, e.g., by encircling with a rubber loop, which significantly facilitates visibility.

Subsequently, the mesentery is gradually transected over Overholt clamps. Distally, towards the specimen, ligatures are applied. Centrally, the mesentery is secured with ligatures or sutures. Centrally, care must be taken to ensure that secure hemostasis is achieved here, so in case of doubt, it is better to use one more suture than one too few.