Temporary Diverting Ileostomy via the Umbilicus: a Small Case Series

Abstract

The umbilicus, a natural orifice, which is used as an access port during laparoscopic surgery, can be used as a stoma site with potential superior cosmetic results as one less incision is then required. Our objective was to assess the efficacy and safety of the umbilical stoma in a selected group of patients. This is a prospective case series in hospital patients admitted as emergency or elective. Patients who underwent laparoscopic colorectal surgery with a planned ileostomy at Box Hill Hospital were approached and invited to participate in the study, with the stoma being fashioned on the umbilicus. Outcomes of interest included demographics, the details regarding the original indication for operation, operative and hospital related outcomes, postoperative bowel related complications, and other surgical and medical complications. Outcomes of a total of 10 (5 males) patients who underwent umbilical covering ileostomy during the study period were analyzed. Two patients with ulcerative colitis had the second stage of their operation converting their end stomas to loop stoma. These were counted twice, totaling 12 stomas in 10 patients. Three patients had their umbistomas after receiving neoadjuvant treatment for rectal cancer. The median period patients have had umbistomas is 113 days. Overall morbidity during the initial operation was low, except for 1 patient who had a small bowel injury. There was no mortality. Minor peristomal skin changes were the most common postoperative complication. Three patients had their stomas reversed with excellent cosmesis. Umbistomas appear to be a safe and effective way to fashion covering stomas post laparoscopic surgery and save the patient an added incision with excellent cosmetic results.

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

“…There are few published reports of umbilical stoma 10,11) . In addition, this study is the first report of the procedure of closing the umbilical stoma established at the time of laparoscopic rectal resection.…”

Feasibility of umbilical loop ileostomy in overweight and obese patients with rectal cancer during laparoscopic surgery: Preliminary results

“…and Mushaya et al . reported more than 10 successful cases of umbilical ileostomy in patients , some at risk of leak, after laparoscopic colorectal surgery, suggesting that the umbilical stoma is a feasible and safe alternative to conventional ileostomy and is cosmetically superior to it. Takedown of the stoma for overweight and obese patients occasionally requires a longer incision than that used for tumor extraction during the primary laparoscopic surgery (Figure ).…”

“…Compared to the traditional stoma sites in the lower quadrants, an umbilical stoma site is associated with less panniculus and is closer to the superior mesenteric vessels. Some recent reports have demonstrated the feasibility of a diverting umbilical loop ileostomy for adult patients undergoing colorectal resection . We speculated that creating a stoma at the umbilicus in overweight and obese patients could confer clinically significant advantages, with fewer stoma‐related complications.…”

Actualización sobre el estoma de protección tras resección anterior baja o ultrabaja por cáncer de recto. Revisión sistemática y nuevas tendencias.

“…La morbilidad global más frecuente fue la relacionada con la piel periestomal. Según los resultados 3 pacientes presentaron estoma invertido con excelente resultado estético [86]. El estudio de Miyo M et al recopila los datos de 83 pacientes intervenidos por neoplasia de recto con RAB con ileostomía de protección.…”