HOW I DO IT / HOW I DID IT SURGICAL PROCEDURES

TRANSVERSE COLOSTOMY

OPERATIVE TECHNIQUE:

  ¶Patient lying supine

¶Asepsis/antisepsis

¶Sterile drapes placed

¶Transverse incision at middle and lateral thirds of the upper right rectus muscle or a midline incision

¶Incise the anterior rectus fascia

¶Incise the rectus muscle transversely

¶Posterior rectus sheath and peritoneum grasp with two clamp

¶Make a small incision between the two clamps

¶Identify transverse colon and bring it out of the transverse incision

¶Make a window in the overlying omentum near the proposed site of colostomy

¶Decompress transverse colon

¶Develop a mesenteric window under the colon by passing a clamp through an avascular portion of the mesocolon

¶Anchor the stoma to the fascia with multiple interrupted sutures of silk 3-0

¶Make an incision, 5cm long, longitudinally along the anterior wall of the colon, in the taenia

¶Suture full thickness of colon wall to the subcuticular layer of the skin with 3‑0 interrupted silk suture