Mayo stand and back table instruments for Colostomy/Stoma Creation/Ileostomy surgery setup
Clamping & Occluding
Cutting & Dissecting
Grasping & Holding
Retracting & Exposing
Suturing & Stapling
What to expect during Colostomy/Stoma Creation/Ileostomy
Stomas can involve the large or small colon (ileostomy). Remember to keep the dirty instruments away from the clean ones. It’s best practice to have a separate “closing table” for closing the abdomen. Mayo scissors, a variety of clamps, needle drivers, suture, irrigation, clean laps, and clean gloves should all be included on this table.
Drapes: Folded towels or 4 utility drapes, laparotomy drape
Surgery Steps: Colostomies are usually made after colon resections/colectomies. A 10 or 15 blade will be used to make an incision in the lower abdomen. A bovie will be used with adsons with teeth or a heavier pickup such at rat-tooths or Bonneys to grasp the tissue. Small retractors such as skinny Richardsons or senns will be used to retract.
Another incision will be made with a fresh blade through the anterior rectus sheath. A hemostat or tonsil will be used to separate the tissue. The previously cut bowel will be pulled through the stoma incision using a Babcock or an Allis.
The bowel would have been stapled and cut prior during the colon resection portion of the surgery, so a fresh blade will need to be used to cut that staple line off now and the edges can be clamped or loosely sutured to the stoma incision with the abdominal incision is closed. Absorbable sutures can now be used to suture the stoma.
The circulator will open up the unsterile colostomy bag to you, and the surgeon will used curved or straight Mayo scissors to cut it to the appropriate circumference. It will be attached to the patient, and the stoma creation is complete.
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