Suite 411, Netcare Unitas / Suite 206, Midstream Mediclinic
STOMA CREATION/CLOSURE
A STOMA IS AN OPENING ANYWHERE ALONG THE LENGTH OF THE BOWEL TO THE EXTERIOR SKIN SURFACE TO CREATE AN ARTIFICIAL ANUS.

Indications:

The procedure is done for the following reasons: inflammatory conditions, functional disorders, injury to the colon or cancers of the colon, rectum and small bowel.

Procedure:

The section/portion of bowel to be exteriorised depends on the location along the bowel which needs to be resected or treated. There are three types of stomas:

  • Ileostomy – performed for conditions such as ulcerative colitis or after the removal of the colon. The transected end of the portion of the small bowel named the ileum is brought through the abdominal wall and a portion is turned inside out and stitched to the skin surface.
  • Double-barrel – usually performed as a temporary measure, the bowel is divided and both ends are brought to the margins of the skin incision and sutured to the skin. (Loop colostomy/ileostomy)
  • Colostomy – performed in order to render a segment of the bowel non-functional. Commonly performed following an anterior resection (resection of portion of large intestine), Abdomino-perineal resection, or as part of a Hartmann’s operation. A mucous fistula may be fashioned in addition to this procedure. This can be performed at several sections of the large intestine.
  • Reversal of Ileostomy or Colostomy – performed in order to restore the continuity of the intestinal tract. If performed open, involves either a circular incision around the stoma or possibly through the previous laparotomy (midline) incision. Reversal of loop ileostomies or colostomies can generally be performed through the circumferential incision around the stoma whereas reversal of end-ileostomies or colostomies usually involves opening the old scar in order to safely access the bowel. The bowel ends are reconnected which is called an anastomosis, and the wound is closed.
  • Bleeding – intra-operatively and/or post operatively
  • Leak of bowel content – due to damage or breakdown of tissue at the area where the bowel was severed
  • Infection – can occur in the wound(s), lungs, drip site or at the location where the operation took place along the bowel
  • Deep vein thrombosis – blood clots forming in the deep veins can occur with any surgery
  • Damage to surrounding structures – nearby structures can be damaged inadvertently although all efforts are made to prevent such damage
  • Reversal of Stoma: Bleeding, infection (intra-abdominal abscess, urinary and wound infection), unintentional perforation of bowel, leak at site where bowels are reconnected, an abnormal opening between the bowel and the skin, paralysis temporary or permanent of the intestines, a narrowing at the site where the bowels are reconnected, reoperation.

After your consultation:

  • Obtain authorization from your medical aid and book your bed for your hospital admission.
  • Carefully read through pre-operative information provided.

Day before surgery:

  • Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist  (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).

Day of surgery:

  • Arrive for admission at indicated time on ‘Code & Consent’ sheet.
  • Change into theatre attire, remove all valuable belongings.

Approximately 60-90 minutes

Duration of hospital stay:

  • 2-6 days (dependent on pain management, general state of patient and first bowel movement)

Activities:

  • Refrain from strenuous activities (incl. exercise) for at least 4 post-operatively

Back to work:

  • Sick leave required post-operatively is approximately 10-14 days

Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:

  • Warming devises in theatre as well as warm intravenous fluids.
  • Intra-operative pain medication through the drip.
  • Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
  • As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
If you experience any worrisome problems, please contact the rooms during working hours or the emergency number (012) 333 6000 after hours.

More procedures performed by Dr Basson & Jeske

ABSCESS DRAINAGE
ABSCESS DRAINAGE

A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.

ADRENALECTOMY (OPEN/LAPAROSCOPIC)
ADRENALECTOMY (OPEN/LAPAROSCOPIC)

AN OPERATION TO REMOVE ONE (OR BOTH) ADRENAL GLANDS.

ANAL FISTULECTOMY
ANAL FISTULECTOMY

THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.

APPENDISECTOMY (LAPAROSCOPIC/OPEN)
APPENDISECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.

BILE DUCT EXPLORATION
BILE DUCT EXPLORATION

THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.

BREAST LUMPECTOMY
BREAST LUMPECTOMY

AN OPERATION TO REMOVE LUMPS/TUMOURS OF THE BREAST.

COLECTOMY
COLECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE COLON.

COLONOSCOPY
COLONOSCOPY

AN ENDOSCOPIC EXAMINATION OF THE LARGE INTESTINE (COLON & RECTUM).

DISTAL PANCREATECTOMY
DISTAL PANCREATECTOMY

THE PANCREAS IS EXPOSED AND FREED FROM THE ADJACENT ORGANS. THE TAIL (DISTAL) HALF OF THE PANCREAS IS REMOVED. THE BLOOD VESSELS THAT GO TO THE SPLEEN PASS THROUGH THE PANCREAS. AS A RESULT THE SPLEEN ALSO SOMETIMES NEEDS TO BE REMOVED.

DRAINAGE PERI-ANAL ABSCESS
DRAINAGE PERI-ANAL ABSCESS

AN INCISION IN THE SKIN NEXT TO THE ANUS TO DRAIN PUS.

ERCP
ERCP

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY, INVOLVES PASSING A FLEXIBLE ENDOSCOPE (DUODENOSCOPE) THROUGH THE MOUTH AND STOMACH TO THE FIRST PART OF THE BOWEL CALLED THE DUODENUM.

FEMORAL HERNIA REPAIR (OPEN)
FEMORAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

GASTRECTOMY
GASTRECTOMY

AN OPERATION THAT REMOVES EITHER PART OF THE STOMACH (PARTIAL) OR THE ENTIRE STOMACH (TOTAL).

GASTROSCOPY
GASTROSCOPY

AN ENDOSCOPIC EXAMINATION OF THE STOMACH.

HAEMORRHOIDECTOMY
HAEMORRHOIDECTOMY

AN OPERATION TO REMOVE COMPLICATED HAEMORRHOIDS (PILES).

INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)
INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN AN AREA WHERE PREVIOUS MUSCLE CLOSURE HAS BEEN PERFORMED (AFTER AN ABDOMINAL OPERATION).

INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)
INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)
LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)

REMOVAL OF GALLBLADDER BY MEANS OF MINIMALLY INVASIVE “KEY-HOLE SURGERY”.

LIVER BIOPSY
LIVER BIOPSY

THE DOCTOR WILL TAKE A VERY SMALL PIECE OF YOUR LIVER (ABOUT 1/50,000TH OF YOUR LIVER) TO SEND FOR FURTHER TESTS.

LIVER RESECTION
LIVER RESECTION

THE SURGICAL REMOVAL OF PART OF THE LIVER.

MASTECTOMY
MASTECTOMY

AN OPERATION TO REMOVE THE ENTIRE BREAST

NEUROSTIMULATOR IMPLANT
NEUROSTIMULATOR IMPLANT

WITH INTERSTIM THERAPY, A SACRAL NEUROMODULATION DEVICE IS IMPLANTED DURING A MINIMALLY INVASIVE PROCEDURE.

NISSEN FUNDOPLICATION (LAPAROSCOPIC)
NISSEN FUNDOPLICATION (LAPAROSCOPIC)

AN OPERATION PERFORMED TO RELIEVE GASTRO-OESOPHAGEAL REFLUX; MOST OFTEN ASSOCIATED WITH A HIATUS HERNIA.

OESOPHAGEAL MANOMETRY
OESOPHAGEAL MANOMETRY

OESOPHAGEAL MANOMETRY IS A TEST THAT MEASURES THE FUNCTION AND MOVEMENT OF THE OESOPHAGUS AND THE CHARACTERISTICS OF THE VALVE BETWEEN THE OESOPHAGUS AND THE STOMACH.

PARATHYROIDECTOMY
PARATHYROIDECTOMY

AN OPERATION TO REMOVE PARATHYROID GLAND/S OR PARATHYROID TUMOURS.

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

A PEG IS A WAY OF INTRODUCING FOOD, FLUIDS AND MEDICINES DIRECTLY INTO THE STOMACH BY PASSING A THIN TUBE THROUGH THE SKIN AND INTO THE STOMACH.

PILONIDAL ABSCESS/SINUS EXCISION
PILONIDAL ABSCESS/SINUS EXCISION

AN ELLIPTICAL INCISION IS MADE REMOVING THE AFFECTED SKIN AND INVOLVED TISSUE OVER THE BUTTOCK CLEFT.

RECTAL PROLAPSE (ABDOMINAL REPAIR)
RECTAL PROLAPSE (ABDOMINAL REPAIR)

AN OPERATION PERFORMED TO REPAIR A RECTUM THAT PROLAPSES THROUGH THE ANUS.

RECTOCELE REPAIR
RECTOCELE REPAIR

AN OPERATION PERFORMED TO STRENGTHEN THE WALL OF THE VAGINA WHICH STOPS THE RECTUM FROM PROTRUDING INTO THE VAGINA.

SMALL BOWEL RESECTION
SMALL BOWEL RESECTION

SURGERY TO REMOVE A PART OF YOUR SMALL BOWEL.

SPLENECTOMY (LAPAROSCOPIC/OPEN)
SPLENECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE THE SPLEEN.

STOMA CREATION/CLOSURE
STOMA CREATION/CLOSURE

A STOMA IS AN OPENING ANYWHERE ALONG THE LENGTH OF THE BOWEL TO THE EXTERIOR SKIN SURFACE TO CREATE AN ARTIFICIAL ANUS.

THYROIDECTOMY
THYROIDECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE THYROID GLAND.

TOTAL PANCREATECTOMY
TOTAL PANCREATECTOMY

REMOVING YOUR WHOLE PANCREAS, YOUR DUODENUM, A SMALL PORTION OF YOUR STOMACH, THE GALLBLADDER AND PART OF YOUR BILE DUCT, YOUR SPLEEN AND MANY OF THE SURROUNDING LYMPH NODES.

UMBILICAL HERNIA REPAIR (OPEN)
UMBILICAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS/SWELLING OF THE NAVEL (BELLY BUTTON).

WHIPPLE’S (PANCREATICODUODENECTOMY)
WHIPPLE’S (PANCREATICODUODENECTOMY)

THIS IS A MAJOR OPERATION TO REMOVE THE HEAD OF THE PANCREAS.