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The ileum (small bowel) is brought through the abdominal wall and stitched to the skin in a convenient site to allow the comfortable application of a stoma bag (or pouch) which is stuck around the open end of the bowel. Faecal material is passed into the bag by peristalsis and the bag changed when full or uncomfortable.
The operation may involve the removal of a portion of the small bowel, colon or rectum or be performed to divert the faecal stream away from the bowel beyond without the need for bowel resection.
When large bowel is removed and the remaining colon and rectum rejoined (commonly an anterior resection) the ileum may be brought out upstream of the join as a loop to protect it while it heals fully. This is known as a de-functioning loop stoma and may also be performed without removing any bowel.
The ileum may be brought through the skin as an end rather than as a loop and the remaining bowel beyond removed or left within the abdominal cavity. The operations are carried out for a variety of disorders including bowel cancer, diverticular and inflammatory bowel disease. The operation is usually performed laparoscopically but an open procedure may be necessary.
The bowel is freed from its attachments within the abdominal cavity where necessary and where appropriate its blood supply is divided. The bowel is then cut and any diseased segment is removed if necessary. The upper end or loop of ileum is brought through a pre-marked site in the abdominal wall after splitting the muscles and removing a small amount of skin and fat. The bowel wall is stitched to the skin with absorbable stitches.