Ostomy Surgery: All You Need To Know

Ostomy, a surgical procedure, creates an alternate opening in the abdomen, altering the way waste exits the body. Surgeons connect the small or large intestine to the skin outside your abdomen during this surgery. This procedure is used to treat a variety of urinary and digestive system diseases.

Conditions that necessitate ostomy surgery

Specific digestive or urinary issues may necessitate ostomy surgery. For instance, you may require an ostomy if you have the following:

● Colorectal cancer

● An injury to the small or large intestine

● Clogged bowel

● Ulcerative colitis 

● Crohn's disease 

● Diverticulitis 

● Bladder Cancer

The procedure of ostomy surgery

Surgeons may perform ostomy creation surgery laparoscopically or through a laparotomy.

Laparoscopic surgery is the least invasive type of surgery. It entails making small incisions in the abdomen and inserting special instruments to allow the surgeon to see inside the abdomen.

A laparotomy is a more open procedure than a laparoscopy. It entails making a large surgical incision to pull back the abdominal skin and allow the surgeon to see inside the belly. A surgeon performing minimally invasive surgery may need to convert to an open approach in approximately 16% of cases.

What happens during ostomy surgery?

During ostomy, the surgeon makes an incision in the abdomen and connects a portion of the intestine to the abdominal wall, allowing stool to exit the body through abdomen rather than rectum.

Some of the steps involved in ostomy creation are as follows:

1. Removing air from the bowel 

2. Making an incision at the chosen loop of the bowel

3. Stitching a section of the bowel to the chosen ostomy site (This hole is known as a stoma and is dark pink in color)

4. A pouch is worn over the stoma

The pouch connects to a unique sticker-like device that sticks to the skin. It functions as a stool or urine collection bag. A stoma lacks muscle, and a person cannot control when waste products exit their body.

The most common types of bowel ostomy surgery are ileostomy, colostomy, and continent ileostomy. The reason for your surgery determines the type of ostomy surgery recommended by your doctor, along with other factors.

The steps of ostomy surgery may differ depending on your specific requirements. Here are some of the most common ostomy procedures:

Colostomy: Any damaged or diseased parts of your colon or rectum are removed by your surgeon. The remaining colon is brought through your abdominal wall and attached to your skin to form a stoma. The stoma is then wrapped in a colostomy bag.

Ileostomy: During this procedure, your surgeon will attach the ileum, the distal part of the small intestine, to the abdominal wall to form a stoma. Then, the ostomy stoma is fitted with an ileostomy bag.

Urostomy: This procedure diverts urine away from a damaged or diseased bladder. During surgery, a section of the large intestine or the end of the small intestine is removed and relocated. Once in its new location, this section of the small bowel creates a passageway for urine to pass through the kidneys and exit the body through your stoma.

J-pouch: Surgeons create an internal reservoir in the shape of a "J" during this procedure. It transports stool from a person's small intestine to a stoma. Doctors recommend this procedure to patients suffering from ulcerative colitis or inherited conditions such as familial adenomatous polyposis (FAP).

Post-operative care during ostomy surgery 

The majority of people require hospitalization following ostomy surgery. The length of hospital stay varies depending on the stoma and surgical approach, but it can be as little as a day or two. During this time, your medical team will monitor you closely to ensure you are healing properly. You may require an intravenous (IV) drip to stay hydrated. A catheter may also be inserted to drain urine. 

Advantages of undergoing ostomy surgery

Ostomy surgery can save a person's life in many cases. In other cases, the procedure treats various digestive and urinary diseases and significantly improves the quality of life.

Disadvantages of ostomy surgery

Ostomy surgery, like any other surgery, can have complications. Complications occur in one-third of planned surgical procedures. They may range from mild to severe and include:

● Intestinal obstruction

● Diarrhea

● Prolapse

● Infection

● Bleeding

● Dehydration

● Ostomy obstruction

● Parastomal hernia

● Electrolyte imbalance

● Skin breakdown

The recovery period following ostomy surgery

It may take up to eight weeks to fully recover from ostomy surgery.

A surgeon may perform an ostomy procedure with the expectation that the ostomy will be temporary. This could be the case for patients suffering from certain types of cancer or who have had abdominal trauma.

A temporary ostomy can help a person's body heal while reducing the possibility of bowel contents leaking into the abdominal cavity.

The Bottom Line

Although ostomy creation procedures save lives, they are not without risk. A nurse or other ostomy care professional can assist a person in improving their ability to manage an ostomy in the post-surgical period.

A close network of family, friends, and support groups can assist a person in receiving the psychosocial support required during and after ostomy surgery.