Clin Colon Rectal Surg 2008; 21(1): 017-022
DOI: 10.1055/s-2008-1055317
© Thieme Medical Publishers

Technical Tips for Stoma Creation in the Challenging Patient

Peter A. Cataldo1
  • 1Department of Surgery, University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, Vermont
Further Information

Publication History

Publication Date:
28 February 2008 (online)

ABSTRACT

Stoma creation is a mental and technical exercise, often straightforward without any difficulty. However, creation of a protruding, tension free, well-vascularized stoma in an obese individual with a thick abdominal wall and short, thickened mesentery can be a substantial challenge. Preoperative planning including stoma site marking, thoughtful consideration of all alternatives, and attention to technical detail will help create a stoma that will serve the ostomate well. The technical tips provided in this article should facilitate the process of selecting the appropriate intestinal segment, identifying the correct stoma site, and creating a functional stoma even in the most challenging situations.

REFERENCES

  • 1 Williams N S, Nasmyth D G, Jones D et al.. Defunctioning stomas: a postoperative controlled trial comparing loop ileostomy with loop transverse colostomy.  Br J Surg. 1986;  73 566-570
  • 2 Unti J A, Abcarian H, Pearl R K et al.. Rodless end-loop stomas: a seven-year experience.  Dis Colon Rectum. 1991;  34 999-1004
  • 3 Cataldo P A. Technical tips for the difficult stoma.  Clin Colon Rectal Surg. 2002;  15 183-190

Peter A CataldoM.D. 

Department of Surgery, University of Vermont College of Medicine

Fletcher 462, Box # 320FL4, 111 Colchester Ave., Burlington, VT 05401

Email: peter.cataldo@vtmednet.org

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