The most difficult regions of the abdominal cavity to expose are either those low in the cul-de-sac and pelvis, or high under the diaphragm.1 Adequate exposure in the upper abdomen can usually be obtained by a generous-sized incision, including the recently devised thoracoabdominal incision. However, in the cul-de-sac and pelvis, actual operative work is not facilitated by an increase in the incision's length, nor even by the use of longer instruments. The reason is understandable, ie, the operating field in the pelvis is unique in that it is limited by the thick bones of the pelvis. In order to facilitate surgery in the pelvic region, therefore, I have devised a special instrument that I describe as a "horizontal abdominal retractor." This report is based upon the application of this instrument in 105 cases.
All current retractors may be classified as right-angled "hooks" that are inserted vertically into the abdominal