Turnbull Stoma
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
The speaker now performs laparoscopy to identify the bowel segment for stoma creation rather than the traditional left lower quadrant incision approach
The technique has recently changed from double barrel to loop stoma
The stoma should be matured on the flat portion of the left lower quadrant between the ribs, anterior superior iliac crest, and pubic bone
The proximal sigmoid should be chosen for stoma creation to preserve the distal sigmoid and rectum for ultimate pull through
The Turnbull loop stoma appears to the world like an end stoma but has a tiny, flat mucous fistula
During double barrel stoma creation, key collateral vessels to the distal segment can be easily ligated when taking mesentery
The Turnbull stoma prevents mesenteric vessel injury because no mesentery is taken
The Turnbull stoma is a loop that functions like an end stoma
The key technical feature is creating a loop with the proximal side brooked and the distal side flat
The stoma site should be on a flat part of the left lower quadrant at some distance from the incision
The bowel is opened on the anti-mesenteric side
The separation between proximal and distal limbs is 90 to 10
The seromuscular layer is tacked to the fascia and the two corners are tacked to the dermis
The main complication related to a loop stoma is prolapse
The proximal limb is turned inside out using a retractor to create the appearance of an end stoma