Stomas

Stomas are commonly formed from either the small intestine or the large intestine. An ileostomy diverts the end of the small intestine (ileum) to the abdominal surface, resulting in a typically liquid or semi-liquid output, which requires careful management to prevent skin irritation. A colostomy, on the other hand, brings part of the large intestine (colon) to the abdominal wall, producing a more formed stool. Stomas may be temporary or permanent, depending on the underlying condition, such as colorectal cancer, inflammatory bowel disease, diverticulitis, bowel obstruction, or trauma.

A Hartmann’s procedure is a type of surgery in which the diseased segment of the colon, often the sigmoid colon, is removed, the proximal end of the colon is brought out as a colostomy, and the distal rectal stump is closed and left inside the abdomen. This procedure is frequently performed in emergency situations, such as perforated diverticulitis or obstructed colon, where immediate reconnection of the bowel is not safe. In selected patients, a Hartmann’s reversal can be performed later, usually several months after the initial surgery, to restore normal bowel continuity. This reversal involves surgically reattaching the proximal colon to the rectal stump, allowing stool to pass through the natural route once again, and closing the temporary colostomy.

Management of stomas requires ongoing education and care, including proper appliance fitting, skin protection, monitoring for complications like infection or blockage, and dietary considerations. Patients undergoing stoma reversal, including Hartmann’s reversal, must be carefully evaluated for overall health, healing capacity, and bowel function to ensure a successful outcome and improved quality of life.

One of our team of surgeons would be happy to meet  with you if you would like to know more about stomas or if you would like to discuss whether it would be possible to reverse a stoma.