Clinical tools to help support your patients

Clinical tools to help support your patients

Get a useful overview of the key issues in ostomy surgery in this section. There is a quick reference to the anatomy and organ systems involved, the common complications that your patients may encounter after surgery and tips and tools to help. 

 


Pre-surgical tools

Assessing quality of life in your ostomy patients

Assessing quality of life in your ostomy patients

The Stoma Quality of Life tool (Stoma-QoL) is a simple, validated questionnaire that can be used to measure quality of life in people with a stoma – and identify the issues that may cause anxiety or concern. Stoma Quality of Life tool
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Assessing quality of life in ostomy patients

People with an ostomy can have many concerns – fear of leakage, embarrassment about their body, worries about becoming a burden to family and friends. When these concerns stop people from doing the things they enjoy, it puts their quality of life at risk.

With the Stoma-QoL tool, healthcare professionals now have a standard and a common language with which to assess quality of life for people with a stoma. You can use the tool to monitor quality of life over time in the same person – or compare quality of life between patients.

Stoma-QoL is:

  • Specifically designed for people with a stoma – all questions are based on input from people with a stoma
  • Validated – tested in representative ostomy populations in different countries
  • Reliable – weighted to emphasize the issues that are most critical to the respondent’s quality of life
  • Cross-cultural – translated into 16 languages
  • Simple – the questionnaire only takes 5–10 minutes to complete

Download the tool:

English

Czech

Danish

Dutch

French

German

Icelandic

Italian

Japanese

Korean

Norwegian

Polish

Portuguese

Slovak

Spanish

Swedish

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Surgical education pad

Surgical education pad

Printable note pages can help explain specific surgical procedures and anatomy to pre-op patients. Download the surgical education pad
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Helpful tools to support your work

Surgical Education Pad
Understanding the basics of a surgical procedure is important for many patients, as it can help them feel prepared and better able to cope. The Surgical Education Pad is an educational tool for proactive patients who would like detailed information about their surgery.

The file includes information on:

  • Abdomino-perineal excision of rectum (APER)
  • Low anterior resection
  • Hartmann’s procedure
  • Total colectomy
  • Restorative proctocolectomy
  • Pan-proctocolectomy
  • IIeal conduit
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Basic anatomy

The digestive system

The digestive system

The digestive system is one of the body's major organ systems. The digestive tract handles the digestion and processing of food. More about the digestive system
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Anatomy and physiology of the digestive and urinary systems

Digestive system

 
The digestive tract stretches some nine metres from the mouth to the anus and is divided into different sections. Each section processes food in a specific way to prepare it for the next section of the digestive tract, until the waste finally leaves the intestinal tract as faeces.

Functions of the digestive system:

  • Mechanical and chemical breakdown of food into basic nutrients
  • Absorption of nutrients into the blood
  • Processing and elimination of waste

A number of organs work alongside the digestive tract, producing fluids and enzymes to aid indigestion:

  • Salivary glands in the mouth
  • Acid fluids in the stomach
  • Liver and gallbladder
  • Pancreas

 

The gastrointestinal tract comprises:

  • Mouth
  • Oesophagus
  • Stomach
  • Small intestine – jejunum & ileum
  • Large intestine – colon
  • Rectum
  • Anus

 

The intestinal wall consists of several layers

 

The small intestine is approximately 5–7 m long in adults. It is divided into three main parts:

  • Duodenum
  • Jejunum
  • Ileum

The jejunum and ileum are connected to the abdominal wall by the mesentery. The mesentery contains arteries, veins and lymph vessels that ensure the transport of oxygen and nutrients to and from the small intestine.

 

The large intestine is approximately 1–2 m long in adults. It is divided into six parts:

  • Ascending colon
  • Transverse colon
  • Descending colon
  • Sigmoid colon, the S-shaped structure
  • Rectum: final part of the digestive tract. Stool collects in the rectal ampulla. A filled ampulla initiates the urge to empty the bowels
  • Anus, terminal opening of the digestive system
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The urinary system

The urinary system

The urinary system is another of the body's major organ systems. The urinary tract is involved in fluid and electrolyte balance, and the excretion of urine. More about the urinary system
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The urinary system

The urinary system

The overall function of the urinary system is to produce and drain urine, removing waste products and regulating the blood's fluid balance. The entire urinary system is located behind the digestive tract.

 

The urinary system consists of:

  • Two kidneys
  • Two ureters
  • Bladder
  • Urethra

The kidneys are two bean-shaped structures that continuously filter the blood, removing waste products and excess water, and balancing fluids and electrolytes. This filtering process results in the production of urine.

 

The ureters are ducts that carry urine from the kidneys to the bladder.

 

The bladder has a dual function. It is both a reservoir that stores urine and a pump that expels urine from the body. The muscle in the bladder wall pushes the urine out.

 

The urethra is a duct connecting the bladder to the outside of the body.

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Basic surgical procedures

Colostomy surgery

Colostomy surgery

A colostomy is a surgically created opening in part of the large intestine which can be permanent or temporary, depending on the disease process. Colostomy surgery
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Colostomy surgery

Formation of a stoma

Colostomy

In a colostomy operation, part of the colon is brought to the surface of the abdomen to form the stoma. A colostomy is usually (but not always) created on the left-hand side of the abdomen. Output consistency depends on where the colostomy is located:

  • Ascending colostomy: Output can range from liquid to pasty consistency and may be irritating to the skin
  • Transverse colostomy: Output is somewhat formed
  • Descending / sigmoid colostomy: Output is formed

 

Because a stoma has no muscle to control defecation, the output it produces will need to be collected using a stoma pouch.

 

There are two different types of colostomy surgery: End colostomy and loop colostomy.

 

End colostomy
If parts of the large intestine (colon) or rectum have been removed, the remaining large intestine is brought to the surface of the abdomen to form a stoma. An end colostomy can be temporary or permanent. The temporary solution is relevant in situations where the diseased part of the bowel has been removed and the remaining part of the bowel needs to rest before the ends are joined together. The permanent solution is chosen in situations where it is too risky or not possible to reconnect the two parts of the intestine.

 

Loop colostomy
In a loop colostomy, the bowel is lifted above skin level and held in place with a stoma rod. A cut is made on the exposed bowel loop, and the ends are then rolled down and sewn onto the skin. In this way, a loop stoma actually consists of two stomas (double-barreled stoma) that are joined together. The loop colostomy is typically a temporary measure performed in acute situations. It can also be carried out to protect a surgical join in the bowel.

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Ileostomy surgery

Ileostomy surgery

An ileostomy is a surgically created opening in the small intestine called the ileum with liquid to pasty consistency. Ileostomy surgery
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Ileostomy surgery

Ileostomy

In an ileostomy operation, a part of the small intestine called the ileum is brought to the surface of the abdomen to form the stoma. Ileostomy surgery is typically performed in cases where the end part of the small intestine is diseased, and is usually made on the right-hand side of the abdomen. Depending on the disease process, ileostomies may be permanent or temporary.

 

The stool can range from a liquid to pasty consistency, and contains enzymes that are irritating to the peristomal skin. Because a stoma has no muscle to control defecation, the output will need to be collected in a pouch.

 

There are two different types of ileostomy surgery:

End ileostomy

End ileostomy

An end ileostomy is created when part of the large intestine (colon) is removed (or simply needs to rest) and the end of the small intestine is brought to the surface of the abdomen to form a stoma. An end ileostomy can be temporary or permanent.

The temporary solution is relevant in situations where the diseased part of the bowel has been removed and the remaining part needs to rest before the ends are joined together. The permanent solution is chosen in situations where it is too risky or not possible to reconnect the two parts of the intestine.

Loop ileostomy

Loop ileostomy

In a loop ileostomy, a loop of the small intestine is lifted above skin level and held in place with a stoma rod. A cut is made on the exposed bowel loop, and the ends are then rolled down and sewn onto the skin. In this way, a loop ileostomy actually consists of two stomas that are joined together.

The loop ileostomy is typically temporary and performed to protect a surgical join in the bowel. If temporary, it will be closed or reversed in a later operation.

 

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Urostomy surgery

Urostomy surgery

A urostomy / ileal conduit is created from a piece of small intestine. The ureters are surgically tunneled into a small segment of the small intestine called a "conduit" or "pipeline". Urostomy surgery
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Urostomy surgery

UrostomyUrostomy

If the bladder or urinary system is damaged or diseased and your patient is unable to pass urine normally, there is a need for a urinary diversion. This is called a urostomy, an ileal conduit or a Bricker bladder.

An isolated part of the intestine is brought onto the surface of the right-hand side of the abdomen and the other end is sewn up. The ureters are detached from the bladder and reattached to the isolated section of the intestine. Because this section of the intestine is too small to function as a reservoir, and there is no muscle or valve to control urination, your patient will need a urostomy pouch to collect the urine.

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