Ileostomy closure - general and visceral surgery

Oval incision around the stoma with a skin margin of about 2 mm wide; dissect through the subcutaneous tissue and possibly close the stoma by suture (here, fixation of the proximal limb with a stay suture for better mobilization and to avoid wound contamination with fecal content of the small intestine).

Free the proximal and distal limbs along their circumference from their adhesions with the subcutaneous tissue down to the fascia while keeping close to the intestine. Here, the stoma is completely freed from the fascia while carefully sparing the small bowel mesentery. Dissect the skin and subcutaneous tissue only as much as appears necessary for safe intestinal suture. Excessive dissection increases the risk of hematoma and/or infection.

After checking with the finger that the stoma has been completely released from the fascia, the loop of the small intestine bearing the stoma can be loosely delivered through the abdominal wall.