Ileostomy surgery is a lifesaving procedure that allows a person to enjoy a full range of activities, such as traveling, sports, work and family life. Placement of the ileostomy is very important to a good outcome.
An ileostomy is a type of ostomy, which is a procedure in which a surgeon brings part of the intestine to the outside of the body to create a stoma. After an ileostomy, the patient’s digestive wastes will pass through the stoma into a pouch instead of through the anus.
Doctors perform ileostomy for patients who have had some sort of injury or illness to their intestinal tract. The procedure allows the patient’s body to dispose of waste. Surgeons typically perform ileostomy on patients to treat inflammatory bowel disease (IBD) or bowel cancer.
Ileostomies may be temporary or permanent. Temporary ileostomies give the small intestine time to heal and can be reversed. A surgeon may perform a temporary ileostomy for a patient who suffers from an inflamed or damaged colon or rectum that needs some time to heal or rest following surgery or injury. The surgeon can repair the opening in the abdominal wall then reconnect the ileum after the patient’s colon or rectum heals. Reconnecting the ileum allows stool to pass into the colon normally again.
Surgeons perform permanent ileostomies when they must remove or bypass the patient’s entire colon, rectum, and anus. These procedures cannot be reversed.
Surgeons perform ileostomy on the lowest portion of the small intestine, known as the ileum. The surgeon usually places the stoma, which is the opening to the outside of the patient’s abdominal wall, on the lower right side of the patient’s abdomen.
The stoma is typically below the patient’s navel but above his or her pubic hair. The surgeon will bring the ileum through the muscle that runs vertically in the abdomen. The muscle, known as the rectus abdominous or “abs,” holds the stoma in place to prevent complications.
Prior to surgery, the surgeon will select an appropriate site for the stoma. Ideally, the stoma should be in an area visible to the patient. Individuals confined to a wheelchair or who have exceptionally large abdomens may benefit from stoma placement in the upper abdomen. Other conditions, such as hernias or scars, may require placement in a different area of the patient’s abdomen.
Surgeons will typically avoid placing the ileostomy stoma on the underside of the abdomen, where the abdomen curves back towards the body if the patient cannot see this area easily. Surgeons will also avoid skin folds and creases, as it is very important to have a flat surface on which the patient can apply a pouch for the collection of waste.