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Complications - Ileostomy reversal (without resection) with skin closure using the gunsight technique

general and visceral surgery
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Intraoperative complications and their prevention

    • Injury to the intestine (especially in cases of severe adhesions → extensive, careful adhesiolysis). In cases of extensive or multiple injuries to the intestinal wall, a small bowel segment resection with new anastomosis should be performed.
    • Bleeding (→ bloodless, careful surgery)
    • If there is poor blood supply to the ends of the connection, an intraoperative resection must be performed.

  2. Postoperative complications and their prevention

    • Peritonitis due to anastomotic leakage or intraoperatively unrecognized injury to other intestinal sections with leakage of stool into the free abdominal cavity
    • Fecal fistula
    • Incisional hernia (→ possibly wearing an abdominal binder for 6 weeks)
    • Postoperative ileus (→ possibly bowel-stimulating measures), caution indirect indication of anastomotic leakage!
    • Postoperative stenosis of the anastomosis (→ good blood supply to the anastomosis, tension-free surgery; reoperation may be necessary in individual cases)
    • Wound infections (→ adequate wound drainage "Gunsight!")