Anticipation of umbistoma in laparoscopic anterior rectal resection: Ileostomy and ostomy closure

Abstract

Abstract:Objective: The use of laparoscopic surgery for rectal disease is expected to provide good cosmetic benefits for patients postoperatively. However, this expectation is significantly reduced when a diverting ileostomy is created. We present a new technique that reduces the size of the skin wound by constructing a diverting ileostomy in the umbilicus. This procedure, diverting umbilical ileostomy (umbistoma) does not require special tools for its construction and closure. Methods: Twenty-nine patients underwent treatment with umbilical diverting stoma, including five women and 24 men, with a mean age of 70 years (range: 40-88 years). At the time of ostomy closure, a new umbilicus was formed by subcutaneously suturing the wound to the fascia. In addition, we did not close the new umbilical upper and lower spaces, so as to allow open drainage of the healing wound. Results: All procedures were completed successfully without any perioperative complications. Conclusions: Our findings suggest that the umbilical diverting stoma could provide improved safety and cosmetic advantages in laparoscopic rectal resection.

Quality of life amongst patients with diverting umbilical stomas in rectal surgery: a single centre prospective randomized controlled pilot study

“…Finally, there was no significant difference in the duration of reversal surgery or the length of stay in hospital post reversal surgery. This corroborates the findings from several other studies 9,23 …”

“…This corroborates the findings from several other studies. 9,23 Incisional hernias at stoma closure sites have been reported as high as 30%. 9,11 Two patients in each group (22.2% RIF vs. 20% umbistoma) experienced incisional hernias following stoma reversal surgery.…”

Umbilical Defunctioning Ileostomy for Rectal Cancer Results in Reduced Risk for Incisional Hernia

“…Since our initial report in 2013 (1), several reports on umbilical defunctioning ileostomy (UDI) have been published from various countries (2)(3)(4)(5)(6). Many of these reports are preliminary studies that discuss the cosmetic advantages of UDI over conventional defunctioning ileostomy (CDI) and feasibility of stoma management.…”

Defunctioning Ileostomy to Prevent the Anastomotic Leakage in Colorectal Surgery. The State of the Art of the Different Available Types

“…Ostomy reversal is performed through a full mobilization of the stoma including the umbilicus, followed by the anastomosis. Finally, the skin is fixed to the muscle layer subcutaneously with two needles to form a new umbilicus ( 19 – 25 ) ( Figure 1C ).…”