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How is a colostomy created? 

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During a colostomy operation, part of the large intestine (colon) is brought to the surface of the abdomen to form a stoma (opening). A colostomy is usually made on the left-hand side of the body, but can also be on the right.

The colostomy can be formed either as an end colostomy or a loop colostomy:

End colostomy
Healthy end colostomy

Healthy end colostomy - some time after operation

An end colostomy is usually formed when parts of the large intestine and/or rectum are removed and the remaining part of the large intestine is brought out to the surface of the abdomen to create a stoma.

An end colostomy can be temporary, and is usually performed when
  • a diseased part of the intestine is removed and the anastomosis must heal without being affected by faeces, or
  • when joining the two ends of intestine is thought to be risky at the particular time
There are two types of frequent end operations: Abdomino-perineal excision of rectum and Hartman’s procedure.



Loop colostomy
Colostomy with bridge

Loop colostomy - just after operation and with plastic bridge

Formed in order to protect an anastomosis, a loop colostomy is expected to be temporary.

Usually, the intestine is lifted above skin level and held in place by an ostomy rod. The surgeon makes an incision on the exposed loop of intestine, and rolls the bowel down before sewing it to the skin. This means the loop ostomy actually consists of two stomas (a double-barrelled stoma) that are connected to one another.

The most common operation is a low anterior resection.

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