Laparoscopic Colostomy
A laparoscopic approach for a transverse loop colostomy can be helpful in the elective situation when construction of a diverting colostomy is the aim of the procedure and when the bowel is not extremely distended.
SCORE™, the Surgical Council on Resident Education, did not classify laparoscopic colostomy.
STEPS IN PROCEDURE
Obtain laparoscopic access and explore abdomen
Choose mobile section of bowel
Place a 10- to 12-mm trocar through proposed stoma site
Pass atraumatic bowel grasper
Confirm that bowel will reach peritoneum without tension
Release pneumoperitoneum and excise circular disk of skin and subcutaneous tissues (leave grasper attached to bowel)
Reinsert trocar over grasper
Enlarge fascial and peritoneal defect
Deliver bowel through incision
Mature colostomy (Chapter 97)
LIST OF STRUCTURES
Colon
Transverse colon
HALLMARK ANATOMIC COMPLICATIONS
