A Report On Bowel Diversion
Bowel diversion is a general term used to describe any surgical procedure during which stool follows an alternate pathway made by a surgeon and is excreted from the body safely in spite of a temporarily or permanently compromised intestine. This procedure is required when the intestine is removed or in the process of healing. Numerous conditions such as intestinal blockages, colonic polyps, irritable bowel syndrome – in particular, Crohn’s disease – and intestinal/colorectal cancers can all result in the need of bowel diversion. A similarity in all of these conditions is the inability of the intestinal passages to perform their respective functions and thus validating a need for bowel diversion. As a result of bowel diversion processes, especially ostomies, patients can be impacted by a range of complications. The distribution of complications tends to vary on the basis of the type of procedure and the cause for the procedure. For example, non-cancer related ostomates tend to experience emotions such as embarrassment and depression as they are concerned with their physical appearance and attractiveness to their partners, family and/or opposing sex.
They may also be concerned about the ability of their ostomy bags to hang on to their bodies and thus experience a severe decrease in physical activity. However, if the ostomy was completed in response to an ailment such as colorectal cancer, the patients tend to experience a greater sense of comfort with the colostomy bags and find optimism to aid them along their recover and battle with cancer. Thus, there exists a variety of psychological impacts in response to bowel diversion surgeries – unfortunately most of which are negative. There are a number of physiological complications as well. A study reports that there is a 44% physiological complication rate among 32 patients who had undergone an ostomy surgery. Some complications included parastomal hernias and fecal fistula. Another study reported that patients also experienced exclusion colitis, pelvic abscess and so on.
New devices and procedures are being developed in order to reduce the prevalence of complications in patients who’ve undergone bowel diversion surgeries. Such devices include the Transcutaneous Implant Evacuation System (TIES), percutaneous implant, and the Alexis retractor. The Transcutaneous Implant Evacuation System (TIES) is much like the percutaneous implant as both consist of cylindrical rings which are placed around the stoma which in turn resolves in a surgery which not only has fewer complications – fewer infections in particular – but also is slightly easier to complete.
The lack of complications and infections when using the devices suggests an improvement in the outcome of the surgery. However, one patient who was treated with TIES experienced leakage and was no longer satisfied with the procedure. The Alexis retractor reduces tension and wound infections when using robot-assisted laparoscopic radical cystectomy. No wound complications in the form of cellulitis or hernia were noted in follow up records for patients who were treated with the Alexis retractor.
