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March 1975

Defunctionalizing a Colostomy

Arch Surg. 1975;110(3):352. doi:10.1001/archsurg.1975.01360090122030

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To the Editor.—Increasing use of stapling devices has prompted us to devise a simplified method for performing a defunctionalizing colostomy.

Often the loop colostomy is employed by the surgeon as a compromise for complete fecal diversion in sick patients because of its simplicity, efficiency, and lack of complications. The technique we use converts this to a completely diverting colostomy by bringing out a loop of bowel through the abdominal wall; placement of a glass rod below the loop of bowel through an avascular segment of mesentery and onto the abdominal wall; ligation of the distal part of the bowel with the 30- or 55-mm automatic stapler (Figure, A); and formation of the

A, Ligation of distal part of bowel with 30- or 55-mm automatic stapler. B, Formation of proximal limb stoma by opening bowel wall with cautery 24 to 48 hours postoperatively. proximal limb stoma by opening the bowel

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