Laparoscopic rapid totally diverting loop colostomy: a new twist on an old technique

A minimally invasive variation of an established technique of colostomy is described. The method was originally published in 1977. In a setting where traditional celiotomy is not required, three ports are placed with the left lateral port used for the stoma. After initial peritoneal inspection, the colon segment and its mesentery are identified. A suture is passed forming a loop through the end of a soft latex drain, which is passed into the peritoneal cavity. Using the Goldfinger instrument, the mesentery is breached and the loop end of the drain is snared and brought back through the mesenteric defect. This maneuver enables the colon to be retracted through the port site for completion of the colostomy. Inserting the finger along the loop provides proximal and distal visual confirmation. The colon is stapled but not divided. Maturation of the stoma may be done immediately or delayed depending on the clinical circumstances.