Saphenous Vein Harvest
Transcript of Saphenous Vein Harvest
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Stoma Creation
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Key Simulated steps and operative Principles
• Creation of an end ileostomy/colostomy • Creation of a loop ileostomy/colostomy
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Goals and Objectives
1. Understand and explain the indications for different types of stomas
2. Use Brooke ileostomy technique to create both a loop stoma and end stoma
3. Manipulate bowels gently to avoid traumatic injury
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Required Materials and Costs
• Babcock • Marking pen • Scalpel • CVD Mosquito • Short Metz • Adson x2 • 3-0 Vicryl (polyglycolic acid suture) on SH needle • Suture scissors
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Setup Step 1
Drill four holes into a plastic box
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Setup Step 2
Suspend pork side using cable ties through the drilled holes on the side of the box
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Setup Step 3
Place small bowel underneath the suspended pork side
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Procedure Step
Make a mark where you want to bring out the stoma
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End stoma
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Procedure Step 1
Using a blade, excise a disk of skin
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Procedure Step 2
Dissect down to fascia and through muscle
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Procedure Step 3
Use a Babcock to bring out the end of the bowel through the defect you just created
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Procedure Step 4
Brooke 4 corners first
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Procedure Step 5
Interrupt the rest with 3-0 vicryl
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Loop stoma
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Procedure Step 1
Excise disk of skin
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Procedure Step 2
Dissect down to fascia and through muscle
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Procedure Step 3
Use Babcock to bring a loop of small bowel through the defect
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Procedure Step 4
Use a clamp to secure the loop stoma to avoid slippage before it is matured
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Procedure Step 5
Create an enterotomy for the stoma
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Procedure Step 6
Brooke 4 corners
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Procedure Step 7
Secure the rest with interrupted
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Checklist
Able mature loop and end stoma in a Brooke fashion Gentle manipulation of bowels to avoid
trauma