If the patient presents as an emergency with obstruction, a nasogastric tube should be passed, intravenous fluids should be started and the patient should be made nil by mouth. Postoperatively, the same measures apply to the elective patient in whom there may be handling of the bowel with adynamic ileus.
The supine patient should have a general anaesthetic. Full neuromuscular relaxation should be instituted to facilitate exposure of the sac and closure. After skin sterilization, drapes should be applied to expose both the umbilicus and the lower abdomen should the need arise for bowel resection.
Some authors use an occlusive film around the operation site to limit the potential spread of sepsis.
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