A colostomy creates a connection between the colon and the outside of the body. The contents of the bowel are allowed to drain into a bag. A colostomy may be temporary or permanent.
Who is a candidate for the procedure?
A colostomy may be performed for many reasons. A colostomy may be needed because of bowel infections, colon cancer, or severe inflammation of the bowel. The bowel may be obstructed, or injured. An infant may have been born with bowel defects that can best be remedied using a colostomy.
How is the procedure performed?
If the procedure is planned, bowel preparation is used. This means that the person takes bowel cleansers and follows a liquid diet for several days before the surgery.
Usually, antibiotics are given to kill bacteria in the bowel. Bowel preparation helps reduce the risk that bowel bacteria will spread to the surrounding tissues during surgery. Bowel preparation is not possible in emergency cases.
A colostomy is done under general anesthesia. This means that the person is put to sleep with medicines, has no awareness of the operation and cannot feel pain. The person is put on an artificial breathing machine, a ventilator, during the surgery. Antibiotics are usually given intravenously for several hours before the operation begins.
The skin of the abdomen is cleaned with a substance that kills bacteria. The main incision is made into the abdomen. The colon is exposed and examined. The surgeon finds the area of colon he or she needs. This section of colon is brought out through the skin, usually through a separate cut in the abdomen. The colon is then attached to the skin of the abdomen with stitches.
A hole is made in the colon to allow feces to drain out of the body. This opening to the outside of the body is called a stoma. The stoma is red and oval, and is like the skin on the inside of the lower lip. A drainage bag is attached to the skin immediately surrounding the stoma. This allows feces to be collected. The main abdominal incision is then closed.
Textbook of Surgery, 1998, Schwartz et al.