To the Editor.—Increasing use of stapling devices has prompted us to devise a simplified method for performing a defunctionalizing colostomy.
Often the loop colostomy is employed by the surgeon as a compromise for complete fecal diversion in sick patients because of its simplicity, efficiency, and lack of complications. The technique we use converts this to a completely diverting colostomy by bringing out a loop of bowel through the abdominal wall; placement of a glass rod below the loop of bowel through an avascular segment of mesentery and onto the abdominal wall; ligation of the distal part of the bowel with the 30- or 55-mm automatic stapler (Figure, A); and formation of the
A, Ligation of distal part of bowel with 30- or 55-mm automatic stapler. B, Formation of proximal limb stoma by opening bowel wall with cautery 24 to 48 hours postoperatively. proximal limb stoma by opening the bowel