Colostomy
Definition
Colostomy is a temporary procedure required to relieve
obstruction of large bowel in babies mostly with:
• Anorectal
malformations and
• Hirschsprung’s
disease.
Objective
• Temporary fecal diversion
• Temporary
decompression of bowel.
Position
• Supine, for right
transverse colostomy for babies with Hirschsprung’s disease
• Supine,
with a folded towel under the left iliac region for sigmoid colostomy in babies
with anorectal malformations.
Anesthesia
General with endotracheal intubation.
Procedure
1. A transverse muscle
cutting incision, 5 cm long at the proposed toma site.
2. Open
the peritoneal cavity.
3. Identify
the colon.
4. Free
the transverse colon from the omentum.
5. Make
a spur of the colon.
6. Fix
the colon with the peritoneum and the abdominal wall muscles in layers.
7. Deflate
the colon with a catheter around a purse string.
8. Open
the colon for 2 to 3 cm along the tinea coli.
Instruments
General set.
Sutures
• Catgut 4/0, 3/0
• Silk
4/0
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