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A simple technic for fixing loop colostomy
A Simple Technic
for Fixing
Loop Colostomy YEU-TSU N. LEE, M.D., Columbia, Missouri
From the Department of Surgery, University of Missouri Medical Center, and the Ellis Fiscltel State Cancer Hospital, Columbia, Missouri.
in place with a purse-string tie. All these methods have not gained popularity, probably because they do not prevent the slippage of the glass rod from underneath the loop of bowel. A simplified technic is illustrated in Figure 2. A short segment of sturdy rubber tubing (the same type as that used with the glass rod) about 1% to 2 inches long is fixed in position longitudinally with two No. 2-O silk stitches. A large cutting needle can assure the deep bites into the skin and the rubber tube. Only when the stitch is cut, can the tube be removed. With a well-fixed short rubber tube in place of the cumbersome glass tubing loop, a transparent disposable bag can be applied immediately. (Fig. 3.) The viability of the exteriorized loop can be inspected readily without undressing and dressing. The disposable bag not only functions well, but also is more comfortable for the patient.
T of loop colostomy
technic, and management have been well established [1,2]. Maydle’s technic of using a small rod (hard rubber, glass probe, sound) to hold the exteriorized colonic loop was described before 1895 [3,4]. Present day technic, as illustrated in Figure 1, in the standard textbooks [5,6] utilizes a long glass rod with a half circle of rubber tubing. A bulky dressing is required to cover the whole area. After initiation of function of the gastrointestinal tract, this bulky dressing is also hard to manage. Gabriel and Lloyd-Davis [7] used a long glass rod only. Cattell [S] illustrated the use of a glass tube with short segments of rubber tubing covering each end. DeAmesti and DeAmesti [9] mentioned fixing the glass rod HE
INDICATIONS,
.c
1
FIG. 1. Conventional
technic for fixing loop colostomy.
FIG. 2. Simplified technic for fixing loop colostomy. FIG. 3. Transparent
disposable bag allows ready inspection of viability of bowel. 138
The American
Journal of Surgery
REFERENCES 1. FALLIS, L. S. Transverse colostomy. Surgery. 20: 249, 1946. 2. WILEY, H. M. and SUGARBAKER, E. D. Colostomy: indications, technique, and management. Surg. Gynec. & Obst., 91: 435, 1950. 3. MOULIN, C. W. M. Surgery, a Practical Treatise with Special References to Treatment, p. 945. Philadelphia, 1895, P. Blakiston. 4. VON ESMARCH, F. and KOWALZIG, E. Surgical Technic, a Textbook on Operative Surgery, p. 700. Translated by L. H. Grau and W. N. Sullivan. New York, 1900. The Macmillan Co. 5. PILLING, G. P., IV, and CRESSON, H. L. Hirschsprung’s disease. In: Pediatric Surgery, vol. 11.
Vol. 116, July 1968
p. 812. Chicago, 1962. Year Book Publishers, Inc. 6. MOYER, C. A., RHOADS, J. G., ALI,EN, J. G., and HARKINS, H. N. Surgery, Principles and Practice, p. 1,030. Philadelphia, 1965. J. B. Lippincott Co. 7. GABRIEL, W. B. and LLOYD-DAVIS. 0. \‘. C,,lostomy. Brit. J. surg., 22: 5X, 1935. 8. CATTELL, R. B. Loop colostomy. In: Surgical Practices of the Lahey Clinic, p. 499. Philadelphia, 1942. W. B. Saunders Co. 9. DEAMESTI, F. and DEAMIESTI, F., JR. Indications and technic for performing cecostomy and colostomy. In: Treatment of Cancer and Allied Diseases, vol. 5, p. 617. Edited by G. T. Pack and I. M. Ariel. New York, 1962. Paul R. Hoeber, Division of Harper and Row.
for Fixing
Loop Colostomy YEU-TSU N. LEE, M.D., Columbia, Missouri
From the Department of Surgery, University of Missouri Medical Center, and the Ellis Fiscltel State Cancer Hospital, Columbia, Missouri.
in place with a purse-string tie. All these methods have not gained popularity, probably because they do not prevent the slippage of the glass rod from underneath the loop of bowel. A simplified technic is illustrated in Figure 2. A short segment of sturdy rubber tubing (the same type as that used with the glass rod) about 1% to 2 inches long is fixed in position longitudinally with two No. 2-O silk stitches. A large cutting needle can assure the deep bites into the skin and the rubber tube. Only when the stitch is cut, can the tube be removed. With a well-fixed short rubber tube in place of the cumbersome glass tubing loop, a transparent disposable bag can be applied immediately. (Fig. 3.) The viability of the exteriorized loop can be inspected readily without undressing and dressing. The disposable bag not only functions well, but also is more comfortable for the patient.
T of loop colostomy
technic, and management have been well established [1,2]. Maydle’s technic of using a small rod (hard rubber, glass probe, sound) to hold the exteriorized colonic loop was described before 1895 [3,4]. Present day technic, as illustrated in Figure 1, in the standard textbooks [5,6] utilizes a long glass rod with a half circle of rubber tubing. A bulky dressing is required to cover the whole area. After initiation of function of the gastrointestinal tract, this bulky dressing is also hard to manage. Gabriel and Lloyd-Davis [7] used a long glass rod only. Cattell [S] illustrated the use of a glass tube with short segments of rubber tubing covering each end. DeAmesti and DeAmesti [9] mentioned fixing the glass rod HE
INDICATIONS,
.c
1
FIG. 1. Conventional
technic for fixing loop colostomy.
FIG. 2. Simplified technic for fixing loop colostomy. FIG. 3. Transparent
disposable bag allows ready inspection of viability of bowel. 138
The American
Journal of Surgery
REFERENCES 1. FALLIS, L. S. Transverse colostomy. Surgery. 20: 249, 1946. 2. WILEY, H. M. and SUGARBAKER, E. D. Colostomy: indications, technique, and management. Surg. Gynec. & Obst., 91: 435, 1950. 3. MOULIN, C. W. M. Surgery, a Practical Treatise with Special References to Treatment, p. 945. Philadelphia, 1895, P. Blakiston. 4. VON ESMARCH, F. and KOWALZIG, E. Surgical Technic, a Textbook on Operative Surgery, p. 700. Translated by L. H. Grau and W. N. Sullivan. New York, 1900. The Macmillan Co. 5. PILLING, G. P., IV, and CRESSON, H. L. Hirschsprung’s disease. In: Pediatric Surgery, vol. 11.
Vol. 116, July 1968
p. 812. Chicago, 1962. Year Book Publishers, Inc. 6. MOYER, C. A., RHOADS, J. G., ALI,EN, J. G., and HARKINS, H. N. Surgery, Principles and Practice, p. 1,030. Philadelphia, 1965. J. B. Lippincott Co. 7. GABRIEL, W. B. and LLOYD-DAVIS. 0. \‘. C,,lostomy. Brit. J. surg., 22: 5X, 1935. 8. CATTELL, R. B. Loop colostomy. In: Surgical Practices of the Lahey Clinic, p. 499. Philadelphia, 1942. W. B. Saunders Co. 9. DEAMESTI, F. and DEAMIESTI, F., JR. Indications and technic for performing cecostomy and colostomy. In: Treatment of Cancer and Allied Diseases, vol. 5, p. 617. Edited by G. T. Pack and I. M. Ariel. New York, 1962. Paul R. Hoeber, Division of Harper and Row.