Monday, August 14, 2017

Pediatric Surgery Colostomy

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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