Hard to Reach Colostomy/Ileostomy

  • Christine Hsieh
  • Sang W. Lee


Difficult stoma formation can be facilitated by variety of surgical maneuvers as described below. Pre-marking the stoma site by an enterostomal therapy nurse is imperative in avoiding the stoma-related complications.


Stoma formation Enterostomal therapy nurse Stoma complications 

Suggested Reading

  1. 1.
    Beck SJ. Stoma issues in the obese patient. Clin Colon Rectal Surg. 2011;24:259–62.CrossRefGoogle Scholar
  2. 2.
    Chu DI, Dozoi EJ. Pearls for the small bowel and colon that will not reach. In: Pawlik TM, Maithel SK, Merchant NB, editors. Gastrointestinal surgery: management of complex perioperative complications. New York: Springer; 2015.Google Scholar
  3. 3.
    Mavroidis D, Kotun WA. Technique for atraumatic delivery of intestine through the abdominal wall during stoma formation. Dis Col Rect. 1996;39(4):461–2.CrossRefGoogle Scholar
  4. 4.
    Meagher AP, Owen G, Gett R. An improved technique for end stoma creation in obese patients. Dis Colon Rectum. 2009;52:531–3.CrossRefGoogle Scholar
  5. 5.
    Person B, Ifargan R, et al. The impact of preoperative stoma site marking on the incidence of complications, quality of life, and patient’s independence. Dis Colon Rectum. 2012;55:783–7.CrossRefGoogle Scholar
  6. 6.
    Whitehead A, Cataldo PA. Technical considerations in stoma creation. Clin Colon Rectal Surg. 2017;30(3):162–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Christine Hsieh
    • 1
  • Sang W. Lee
    • 2
  1. 1.Keck School of Medicine – University of Southern CaliforniaLos AngelesUSA
  2. 2.Department of Surgery – Colon and Rectal SurgeryKeck School of Medicine of University of Southern CaliforniaLos AngelesUSA

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