The peritoneal incision is fraught with potential hazards. Once a good view of the peritoneum is obtained in the depths of the wound, two small artery forceps are used to pick up its surface. The forceps are gently elevated away from the peritoneal cavity. The peritoneum between the tips is palpated to ensure that no loops of bowel lie between them. If this area is free from deeper gut, a small cut is made through the peritoneum along the line of the main wound. In so doing, air is able to enter the peritoneal cavity. Peritoneal fluid may appear at the site; if purulent, this should be documented and the pus sent for microbiological testing.
Scissors are passed into this incision and again with the peritoneum lifted so as to avoid cutting bowel, the incision is extended.
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