Laparoscopy for Stoma Repair

[matthewg144]

Hey everyone, I have had a colostomy for about 8 years now and haven't had any issues up until about 8-12 months ago. It began to retract or recede, now being at or below skin level for the most part. No trauma over over exertion that I know of played a part in this and I haven't gained any substantial weight in the last 4-5 years. Along with this of course comes dealing with the wafer and trying to keep a good seal. So far I have accomplished this by building up the area around the retracted stoma to meet with the wafer, filling the gap and extending my wear time for more then a day to about three. I read somewhere that stoma repair could be done via laparoscopy but haven't found too much information about this. Overall I my Crohn's is controlled with Remicade and haven't had any major issues in years. I would opt for surgical correction because I feel any wafer adjustment or change really is not going to give me the results or stoma I used to have and at this point in my life an extended downtime really would not be a good thing. Anyone here have similar experiences? Your input would be greatly appreciated!

FYI I am seeing my doctor at the end of the month for an opinion which will probably be deferred to a surgeon but just wanted to get some ideas.

 

[2thFairy]

Stoma repair shouldn't require use of a laparoscope since the procedure is done on the surface of the skin. Parastomal hernia repair is sometimes done laparoscopically so as to not disrupt the existing stoma, but you are talking about needing to bring the stoma out from the surface only, right? That's a relatively simple procedure that doesn't require much instrumentation.

Why not try a convex wafer? Seems like the thing to do before surgery.

 

[matthewg144]

I'm glad to hear you say it is a simple procedure. Do you know what is typically involved in doing this, hospital time etc? Also, how is it attached? That is something I guess I never quite understood.

Convex wafers may be worth a try but at this point I feel like it may just be a band-aid solution but maybe a talk with a wound care nurse could offer more insight. Over the last several years the stome above the skin with the combination of products like skin tac made for a very secure, long lasting appliance.

 

[UnXmas]

My first stoma (ileostomy) retracted and had to be surgically corrected urgently as the output couldn't get out. It was a very quick procedure though. I'm sorry but I don't know the details, it was done in such a rush. My second stoma retracted but as long as I used a convex bag I had no problems. Emergency surgery resulted in my third stoma, which is prolapsed, but retracts multiple times a day. Again, with a convex bag I have no issues. I tried mouldable rings and other accessories to try to stop leaks with my retracted stomas, but a convex bag seems to be the answer for me. I hardly ever get leaks.

Edit: I can't help with your questions about the length of hospital stay, etc. as my retracted stoma was fixed under such unusual circumstances, but it was laparoscopic, so I'd think that anything you have done that's not in an urgent situation must if anything be even more simple (though I do have an absolutely wonderful surgeon who specialises is laparoscopy and uses robots - I love boasting on his behalf - so I can't say so for sure).

But definitely try convex bags - there are different depths of convexity available also. Easy to try a few out. I was amazed by how they fiixed my leaking issues that began when my stoma retracted. Especially as I had already tried my stoma nurses' other recommendations without success.

 

[matthewg144]

How long was your stay after the laparoscopic procedure even though it was an unusual circumstance and how long was your recovery time? My stoma is a little uneven as well, always has been even when it was all the way above the skin. The top part sticks out a little while the bottom part is flush or below skin level. It causes some irritation and the convex wafers may help for awhile but I truly feel like I was able to be more active and worry less about everything going on down there when the stoma was well above the skin. My job can cause me to bend from time to time and as of right now I am always weary of the wafer allowing some leakage under it and so on.

 

[UnXmas]

Have you already tried convex wafers? What do your stoma nurses say?

 

[matthewg144]

I know my original post here is a few months old but recently got around to seeing a stoma nurse. They made some recommendations but at the end of the day I wound up still have issues with the wafer being usable for more than a day or two at best. I saw a surgeon about a month ago and have had a CT done to determine whether or not a hernia was causing the retraction, so far it sounds like this is not the case. Monday I am having a colonoscopy to see the extent of the scar tissue to allow the surgeon to decide the amount of intestine causing my problem. One of the things I forgot to ask him is the length of the hospital stay for this procedure. I am guessing it could be longer then a night/day if this is an external type procedure like 2thfairy said above. I'd like to hear anyone else's experience with this type of procedure and how long time your recovery took etc.