Colostomy/Stoma Creation/Ileostomy

Mayo stand and back table instruments for Colostomy/Stoma Creation/Ileostomy surgery setup

Clamping & Occluding

  • Curved Hemostat

    Curved Hemostat

  • Tonsil Clamp

    Tonsil Clamp

Cutting & Dissecting

  • Curved Mayo Scissor

    Curved Mayo Scissor

  • Metzenbaum Scissor

    Metzenbaum Scissor

  • Straight Mayo Scissor

    Straight Mayo Scissor

Grasping & Holding

  • Adson Forceps

    Adson Forceps

  • Allis Forceps

    Allis Forceps

  • Babcock

    Babcock

  • Bonney Forceps

    Bonney Forceps

  • Forester Sponge Forceps

    Forester Sponge Forceps

  • Toothed Forcep

    Toothed Forcep

Retracting & Exposing

  • Army-Navy Retractor

    Army-Navy Retractor

  • Richardson Retractor

    Richardson Retractor

  • Senn Retractor

    Senn Retractor

Suctioning

  • Poole Suction Probe

    Poole Suction Probe

Suturing & Stapling

  • Mayo-Hegar Needle Holder

    Mayo-Hegar Needle Holder

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.

Positioning: Supine

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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