Doctor insights on:
Diverting Colostomy Procedure
Entire Large intestines & rectum removed. Brooke Ileostomy created. Can Brooke Ileostomy later be reversed using the rectal stump?
Your PMD..: Your PMD/Surgeon will answer it better.....too many variables ......not disclosed. ...Read more
Diagonised with rectal cancer, after ileostomy reversal, frequent bm's, abcess withleakage at the surgery site. alternatives tocolostomy ?bowel trnspl
Insert drain: Ileostomy after rectal cancer is used to protect the rectal resuturing to establish continuity in the bowel. II there is some kind of abscess and leakage it can occur where the ileostomy has been reversed or at the site of the rectal suture line which may not have been ready for closure. Interventional radiology can place a suction drain to the site and left there until everything has healed. ...Read more
Operations: In terms of ultimate weight loss, the bypass would be #1 followed closely by sleeve. The band would be a distant third. For fixing problems like diabetes, high blood pressure, high cholesterol, sleep apnea, the ranking is the same. Sleeves are a good option for someone without diabetes or heartburn. If you have those problems or have a bmi over 50, the bypass is a better option. ...Read moreSee 2 more doctor answers
Carefully!: Using 4-5 small incisions we free up all the attachments of the colon and rectum. Then we divide the rectum above the anal muscles or sphincters and make an extraction incision. About 3 inches in size. After removal of the colon and rectum we create the pouch and then attach it to the anal muscles. Sometimes you need a bikini incision to help with the pelvic part of the surgery. ...Read moreSee 1 more doctor answer
Many possibilities: Many things can cause a leak--poor blood supply, too much tension on the anastomosis, poor nutrition, use of immunosuppresants such as steroids, infection, distal obstruction, etc. A recent large study from Germany showed a leak occurs in around 10% of cases. Sometimes it's treated with bowel rest and drainage of the fluid, sometimes it requires another operation. ...Read more
Mostly...: Modern bariatric procedures have become more standardized and safer. However, you need to go through a complete evaluation process to determine whether it is right for you. The most important decision is perhaps picking the right program with a good record. ...Read more
If patient had total colectomy with Ileostomy placement, can they have a surgical procedure involving ileum to sigmoid/left colon several yrs later.
YES: if one performs a left colectomy, even extending the dissection below peritoneal reflection, as long as there is a rectal stump, 1-2 cm above the levators, proximal bowel can be reanastomosed. One can creates a pouch from the proximal bowel to make anastomosis easier and have the pouch act as a partial reservoir for the liquid feces in the ileum that will be used for anastomosis ...Read more
Can an Ileoproctostomy be performed after a subtotal colectomy with Ileostomy placement has already been done?
Yes: After removal of all colon to the peritoneal reflection or just below, there is a stump of distal bowel that remains. In many cases the surgeon can anastomosis proximal bowel to the anal stump at the levators . (the muscles of the rectal sphincter). If an exiting ileostomy is present, a pouch can be formed and anastomosed to the region just above rectum. ...Read moreSee 1 more doctor answer
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