Segmental jejunal resection with side-to-side anastomosis

Small median laparotomy, depending on the location of the findings in the small intestine either superior, periumbilical or inferior to the umbilicus.

It should be noted that laparotomies in the lower abdomen result in better cosmesis. The initial skin incision should be about 8 cm long. This usually suffices to exteriorize the small intestine but, if necessary, the skin incision can be extended. As a rule, any incision involving the umbilicus should skirt it on the left.

When an anastomosis is likely, it is advisable to first protect the edges of the skin with an incise drape or moist towel and insert the retractor afterward.