Alumi Laparoscopic Discussion Board

Anterior rectus sheath fixation during ileostomy/ colostomy?
Discussion in 'All Categories' started by Dr Alankrith Ramesh Kashyap - Jun 1st, 2023 10:57 pm.
Dr Alankrith Ramesh Kashyap
Dr Alankrith Ramesh Kashyap
Good morning sir

Is it necessary to fix the seromuscular layer of stoma to anterior rectus sheath before enterotomy during maturation of ileostomy or colostomy?

There are different schools of thought...

One says that rectus sheath fixation prevents paranormal herniation & retraction...

Another says, that rectus sheath fixation causes dense adhesions & makes it difficult during stoma reversal leading to resection- anastomosis...

What is the latest accepted guidelines ?

Thank you sir
re: Anterior rectus sheath fixation during ileostomy/ colostomy? by Dr, Bhalla - Jun 6th, 2023 3:38 pm
Dr, Bhalla
Dr, Bhalla
The decision to fix the seromuscular layer of the stoma to the anterior rectus sheath before enterotomy during the maturation of ileostomy or colostomy can vary among surgeons, and there is no universally accepted guideline that applies to all cases. The choice depends on multiple factors, including the surgeon's experience, patient-specific considerations, and institutional practices.

Some surgeons advocate for fixing the seromuscular layer to the anterior rectus sheath to prevent potential complications such as parastomal herniation and retraction. This fixation can provide additional support and stability to the stoma, reducing the risk of prolapse or herniation.

On the other hand, some surgeons express concerns about the potential for dense adhesions resulting from rectus sheath fixation. These adhesions may make subsequent stoma reversal surgeries more challenging and potentially necessitate a resection-anastomosis procedure instead. Surgeons who follow this approach prioritize the ease of reversal and minimizing the risk of complications related to adhesions.

Given the differing opinions and lack of a consensus guideline, it is essential for surgeons to consider the individual patient's characteristics, the specific stoma location, and the surgeon's expertise when making a decision. They should evaluate the potential benefits and risks of rectus sheath fixation on a case-by-case basis and discuss these considerations with the patient to reach an informed decision together.
Post Reply
Name *
Email * Will be hidden from visitors
Your Avatar * Limit 2Mb please
Enter verification code Simple catpcha image
* - required fields

In case of any problem in starting laparoscopic discussion please contact | RSS

World Laparoscopy Hospital
Cyber City
Gurugram, NCR Delhi, 122002

All Enquiries

Tel: +91 124 2351555, +91 9811416838, +91 9811912768, +91 9999677788

Need Help? Chat with us
Click one of our representatives below
Hospital Representative
I'm Online