Key principles
• Done in the setting of an obstructing distal colonic tumour o Dilated proximal colon filled with large column of stool o Benefits - Reduction in colon size to facilitate dissection and anastomosis - Reduce contamination or potential for in the setting of a distal anastomosis
Operation Details
• This can be done via an open or laparoscopic approach • Proprietary devices are available • Key steps o Foley catheter into TI or future ileostomy site or use appendix o Decompression of feaces etc 1st through this early in the case o Following dissection and specimen resection the distal end of the colon is secured to a large bore (“Elephant”) tube and connected to drainage system o Irrigation of several litres of warmed saline through catheter and collection in drainage system o Continue with distal anastomosis as planned and closure of Enterotomy or formation of ileostomy