In theory you could bring up your distal limb and do a double barrel colostomy, but that is almost never done for several reasons. #1, the correct resection to perform for a hartmanns is from just proximal to the diseased segment of colon, all the way down to the rectum. This gives you your best chance at preventing recurrence. If your stump is just rectum, there is no way you are going to be able to mobilize that enough to reach the abdominal wall to turn it into a mucous fistula (recall that the rectum is defined as the extension of the colon into the pelvis distal to the peritoneal reflection- see our anorectal anatomy video for a visual on this). #2 there is no distal obstruction, so the limb will easily decompress out the anus, so there is no need to spend the extra operative time (in usually a fairly sick patient) trying to mobilize that colon enough to create a double barrel ostomy. Hope that's clear.
could you do a double barrel colostomy for the last scenario?
In theory you could bring up your distal limb and do a double barrel colostomy, but that is almost never done for several reasons. #1, the correct resection to perform for a hartmanns is from just proximal to the diseased segment of colon, all the way down to the rectum. This gives you your best chance at preventing recurrence. If your stump is just rectum, there is no way you are going to be able to mobilize that enough to reach the abdominal wall to turn it into a mucous fistula (recall that the rectum is defined as the extension of the colon into the pelvis distal to the peritoneal reflection- see our anorectal anatomy video for a visual on this). #2 there is no distal obstruction, so the limb will easily decompress out the anus, so there is no need to spend the extra operative time (in usually a fairly sick patient) trying to mobilize that colon enough to create a double barrel ostomy. Hope that's clear.
Best and well explained, true miracle ❤❤❤
So informative! deserves more views
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Great work sir