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Caecostomy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

A caecostomy is an artificial stoma formed between the caecum and the abdominal wall

can be used effectively to allow colonic irrigation in an unprepared, obstructed colon prior to resection of the obstructing lesion and primary anastomosis
a caecostomy is not good for decompressing the colon nor protecting an anastomosis (1)

To carry out on-table lavage, a large Foley catheter (26-28F) is inserted via a stab incision in the right iliac fossa. Ideally, this gains access to the caecum by an existing caecostomy or an appendicectomy. The catheter is held in place with a Vicryl purse-string suture. The balloon is the inflated and the caecum is secured to the anterior abdominal wall. 8-10 litres of warm saline is then introduced via the catheter and massaged towards the distal colon proximal to the planned site of resection. The fluid exits via wide-bore scavenger tubing. After resection and anastomosis, the catheter is directed towards the ileum to facilitate decompression.

Reference:

1) Down, G.M. and Leaper, D.J. (1994). Abdominal stomas. Surgery, 12:1, 1-7.

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