What is a stoma?

A stoma is a surgically created opening of bowel or urinary tract to an external surface.

What different types of stoma do you know?

• Loop colostomy or ileostomy.

• End colostomy or ileostomy.

• Urostomy to divert urine used after a cystectomy to collect urine from the ureters.

• Gastrostomy or jejunostomy used for feeding patients with functioning gut that are unable to take food orally.

• Caecostomy that is created by intubating the caecum with a Foley catheter usually through the appendicular stump after performing an appendicectomy.

Where should the stoma be sited?

It is necessary to plan the exact site of stoma pre-operatively by involving the patient. This has been shown to improve outcome. The optimal site of stoma placement should be marked preoperatively. This should be on flat skin, away from scars and avoiding bony prominences and the umbilicus. The positioning of the patients clothing should also be taken into account.

There is usually a stoma therapist on site for this.

Where are stomas normally sited?

The usual site is halfway between the umbilicus and the anterior superior iliac spine in the iliac fossa. Ileostomies are usually sited on the right and colostomies on the left.

In what circumstances are temporary stomas used?

Temporary loop stomas are used to allow diversion of faeculant material away from a distal part of the bowel to allow healing of an anastomosis or fistula. Common types include loop ileostomies following anterior resection.