Median laparotomy starting at the symphysis and terminating a few centimeters superior to the umbilicus. (It is very important to carry the skin incision down to the symphysis because otherwise this would greatly impair access to the lesser pelvis). If necessary, mobilize the bladder somewhat. Insert a circular wound edge protector followed by a retractor. Intraoperative exploration.
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Skin incision and exposure
![Skin incision and exposure]()
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Freeing the sigmoid laterally
Retract the colon mediad and sharply divide the lateral peritoneal adhesions of the colon with the
Retract the colon mediad and sharply divide the lateral peritoneal adhesions of the colon with the
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