I have one question. What are options for elimination of waste after total colectomy?
There are three options: standard ileostomy, continent ostomy, and ileo-anal pull-through.
First option is called standard ileostomy and it is considered a gold standard. The end of the small intestine is brought to the abdominal wall and then opening is created in the side of the abdomen below the last rib. Then intestinal contests are drained to the bag that lies against the abdomen, which is emptied when it becomes full.
Second procedure is called content ostomy and is formed when an internal pouch is created under the abdominal wall to collct waste (valve is created at the ostomy site). No external apparatus needs to be worn.
Third case presents ileo-anal pull-through, which allows elimination through the anus. In this case, the surgeon leaves the muscular sleeve of the rectum intact and attaches the ileum to this sleeve, then a small J-pouch is created to hold some intestinal content.