A Novel, Easy, and Safe Technique to Repair a Stoma Prolapse Using a Surgical Stapling Device

Abstract

A stoma prolapse is one of the late complications and often occurs when the stoma is made in an emergency situation. This complication is not lethal, but causes irritable stoma, skin trouble, and difficulty in stoma care. We herein report the case of a 48-year-old female with an end colostomy that was created as an emergency operation 4 months before. On admission, her colostomy protruded approximately 20 cm from the skin with marked redness, swelling, and erosion; it was impossible to treat manually. We repaired the prolapse successfully in a simple procedure with a Proximate Linear Cutter 100. Briefly, under mild sedation, the instrument was diagonally inserted into the prolapsed stoma and applied twice on both sides. Then, the base of each divided tissue was stapled and cut with the same device. Finally, the prolapse was completely repaired without major bleeding and severe pain. We have applied this novel technique successfully in 5 further cases, and there have been no complications or recurrences. This technique can be performed without spinal or general anesthesia and seems to be a very useful procedure for patients with prolapse of a stoma.

Mesh Anoplasty- An Unique Approach to Rectal Prolapse

“…The following two types of rectal prolapse can occur: complete prolapse and incomplete prolapse. [2] A complete prolapse is defined as a protrusion of the full-thickness colon/rectal wall, whereas an incomplete prolapse is defined as a protrusion of the rectal wall within the anal canal. The treatment options differ for each condition and here we describe surgical treatment for the complete rectal prolapse.…”

“…Many procedures are reported to repair rectal prolapse and the procedure used depends on the severity of the prolapse and the status of the patient. [2,3,4,5,6] However, surgical intervention is the mainstream treatment. In elderly and fragile patients, perineal approaches are preferred; for example, Delorme's procedure with or without the Thiersch procedure and the Gant-Miwa procedure are options for mild rectal prolapse, whereas Altemeier's procedure is the treatment of choice for severe rectal prolapse.…”

Stoma Prolapse

“…This can be achieved using a stapling device; there are various techniques described in recent literature using a linear, circular, or contour stapler. [21][22][23] Revision Revision is most appropriate for prolapse of the distal limb of a transverse loop colostomy. In this case, through peristomal skin incision, the distal limb is dissected free and separated from the proximal limb.…”

Stoma prolapse and stoma retraction

“…There is clearly a demand for a structured scientific clarification as the occurrence of stomal retraction or prolapse may present psychological and medical problems for the patients and therefore needs to be treated, conservatively and/ or operatively, by both stoma specialists and surgeons. [5]. Beide Vorgehensweisen sind in der Literatur bei prolabierten Kolostomata beschrieben und sind nach Angaben der Autoren in geeigneten Fällen in Lokalanästhesie durchführbar.…”