Reference no: EM133705051

Question

Indication for Procedure: This is a 57-year-old female who underwent an open low anterior resection for complicated diverticulitis. Due to the complex nature of the surgery, a diverting loop ileostomy was constructed. The patient did well. She is for elective ileostomy closure. Risks of surgical procedure, alternatives, and benefits have been discussed preoperatively. Description of Procedure: Patient was brought to the operating room and positioned in supine position. General endotracheal anesthesia was induced. The abdomen was prepped and draped in sterile fashion. An elliptical incision was carried around the ileostomy. The ileostomy was freed from the subcutaneous tissues. Careful dissection freed ileostomy from the abdominal wall. With the small bowel freed, skin adherent to the ileostomy margins was excised, but the ileostomy was unraveled. Both ends appeared satisfactory for primary closure. The loop ileostomy was then closed with interrupted 3-0 silk suture. The closure examined carefully and found to be satisfactory. The bowel was returned to the peritoneal cavity. The abdomen was irrigated. The abdominal wall was closed with figure-of-eight #1 Vicryl suture. Wound was irrigated. Skin was closed over a quarter-inch Penrose drain with surgical staples. The patient tolerated the surgical procedure well. Sponge and needle counts were correct.