TRANSVERSE COLOSTOMY

Operative Technique

Patient supine under General Anesthesia

Asepsis and antisepsis technique

Sterile drapes placed

Midline incision made

Intra-operative findings noted

Transverse incision made over the middle and lateral thirds of the upper right rectus muscle; incision carried from skin through subcutaneous tissue, anterior rectus fascia incised, muscle splitting, posterior rectus sheath and peritoneum cut and opened

Transverse colon identified, including proximal and distal portions

Transverse colon exteriorized and secured with a Babcock

Midline incision closed layer by layer

Suture placed on the seromuscular layer of exteriorized colon to the fascia in 3 quadrant manner in each portion of the colon

Incision made longitudinally along the anterior wall of the colon, preferably in the taenia

Immediate maturation of colostomy done

3-point seromuscular suture made on the colon wall to the subcuticular layer of the skin using interrupted 4-0 silk sutures

Dry sterile dressing over midline incision

Colostomy bag placed