postheadericon Turnbull Blowhole Technique: A Loop Ileostomy – Colon And Rectal Surgery

A short incision is made paramedian left to find a loop of distal ileum proximal to a terminal ileal disease. A lower midline incision may be substituted which can be incorporated into an incision used for a subsequent operation. The terminal ileum is exteriorized through an incision right lower quadrant and hanging above a bar. A 5-cm incision epigastric or right upper quadrant is made on the expansion zone of maximum transverse colon to the vent. The device incision is closed. The ileostomy is matured primarily as a loop. The blowhole colostomy is matured in two layers. The seromuscular layer of the intestinal wall is attached to the fascia with several stitches running, leaving a few centimeters of the serosa exposed in the middle. The light is entered and the entire thickness of the intestinal wall is carefully sutured to the skin with simple interrupted sutures. No attempt is made to evert the stoma because the tissue is susceptible to tearing. The devices are placed on both the stoma. Over the years, remarkable results have been reported in patients who are seriously ill with an expected high mortality.50, 51 al.52 and Remzi of the Cleveland Clinic recently reported their findings, noting that even in a clean Turnbull the procedure was rarely performed now. They described 17 patients over 18 years who underwent this procedure for inflammatory bowel disease, Clostridium difficile colitis, a disease of adult Hirschsprung’s, and palliation for malignant bowel obstruction with metastases . Two of the patients with inflammatory bowel disease were pregnant. All four patients with metastatic carcinoma died of their disease. Twelve of the remaining 13 patients were reconstructed, all with good results. Clearly, the indications for this procedure have decreased in recent decades because of better health

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