A colostomy is a surgical procedure that creates an opening, known as a stoma, for the colon (large intestine) through the abdomen. This allows waste to exit the body through a new pathway. A loop colostomy represents a specific type of colostomy, often implemented as a temporary measure to divert the colon.
What is a Loop Colostomy?
A loop colostomy involves bringing a section of the large intestine, or colon, through an incision in the abdominal wall. Surgeons then open this loop, creating a stoma on the surface of the abdomen. This stoma uniquely features two distinct openings within what may appear as a single large stoma. One opening, the proximal limb, connects to the functioning part of the bowel, allowing stool to exit the body. The other, the distal limb, leads to the inactive portion of the bowel that continues to the anus, which may discharge mucus. This configuration allows for temporary waste diversion.
Reasons for a Loop Colostomy
Loop colostomies are frequently created when a part of the colon requires a temporary period of rest and healing. This allows the affected bowel segment to recover without stool passage. Conditions such as inflammatory bowel disease flare-ups, diverticulitis, or infections can necessitate this procedure. A loop colostomy may also be performed to protect a new surgical connection, or anastomosis, lower in the bowel, preventing contamination during the healing process.
In emergencies like bowel obstructions or injuries, a loop colostomy provides temporary relief, decompressing the bowel or bypassing the injured area. It is often chosen for its easier reversibility, suitable when normal bowel function is expected to be restored.
The Loop Colostomy Procedure
Loop colostomy creation typically occurs under general anesthesia. The surgeon makes an incision in the abdomen, through which a loop of the colon is carefully brought to the surface. This loop is then opened and everted, or folded back, to form the stoma, which is then stitched to the skin of the abdominal wall.
A temporary support rod or bridge may be placed underneath the exteriorized loop to hold the stoma in position during the initial healing phase. This device helps prevent the stoma from retracting back into the abdomen. The support rod is generally removed a few days after the procedure, once the stoma has stabilized. The surgical approach can vary, with some procedures performed through open surgery and others using minimally invasive laparoscopic techniques.
Life with a Loop Colostomy
Immediately following the procedure, the stoma will appear moist and red, similar to the inside lining of the mouth, and may be swollen. It typically takes several weeks for the swelling to subside and for the stoma to reach its final size. Stool and gas will begin to exit through the stoma, collecting in an external pouch, or ostomy bag, that adheres to the skin around the stoma.
Patients receive guidance on how to manage the ostomy pouch, including emptying and changing it. The consistency of the stool in the pouch can vary depending on the location of the colostomy within the large intestine. While the primary exit for stool is the stoma, the colon remains connected to the rectum, and some individuals may still pass mucus or small amounts of stool through the rectum.
Loop Colostomy Reversal
A loop colostomy is temporary and designed for potential reversal. The reversal procedure involves reconnecting the two ends of the bowel that were separated to form the stoma. The stoma is then closed, and the bowel is returned to the abdominal cavity.
The timing for reversal varies depending on the patient’s overall health and the resolution of the underlying condition that necessitated the colostomy. Reversal typically occurs several weeks to months after the initial surgery, commonly within 3 to 12 months. This subsequent surgery is generally less extensive than the initial colostomy, though it still requires a recovery period. The goal of reversal is to restore normal bowel function.