Stoma creation through the stoma site: a rapid, safe technique

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Conventional stoma creation often requires a separate laparotomy incision, increasing patient morbidity.
• Laparoscopic approaches have been proposed to reduce complications associated with open stomal techniques.

Purpose of the Study:

• To describe and evaluate a novel technique for stoma creation performed directly through the stoma site.
• To assess the safety and efficacy of this closed technique, avoiding both laparotomy and laparoscopy.

Main Methods:

• Retrospective review of patient charts for 36 individuals who underwent attempted stoma creation using the closed technique.
• Comparison of outcomes between patients successfully treated with the closed technique and those requiring conversion to open laparotomy.

Main Results:

• An 89% success rate was achieved with the closed stoma creation technique (32 out of 36 patients).
• The closed group demonstrated significantly lower blood loss (17 vs. 350 ml), operative time (52 vs. 169 minutes), and complication rates (3/32 vs. 4/4) compared to the open group.
• No contraindications for the closed technique were identified based on diagnosis, obesity, or prior abdominal surgery.

Conclusions:

• Stoma creation is feasible and safe in a high proportion of patients using the described closed technique, eliminating the need for laparotomy or laparoscopy.
• Patients failing the closed technique may represent a high-risk group for open stoma creation, potentially benefiting from laparoscopic approaches.