What is closure of a loop ileostomy?

A loop ileostomy is a type of stoma (your bowel opening onto your skin) and was made with two ends of your small bowel. It was expected that this would be only temporary and that your bowel ends would be put back together.

Your bowels will then open in the usual way.

What are the benefits of surgery?

You should be able to open your bowels in the normal way and you should no longer have a stoma bag.

What will happen if I decide not to have the operation?

Your bowel will continue to open onto your skin and you will need to carry on using a stoma bag.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes about an hour.

Your surgeon will make a cut on your skin around the ileostomy. They will free up the loops of small bowel used to make the ileostomy. Your surgeon will join the two ends back together and place the joined bowel back inside your abdominal cavity.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• Bleeding during or after the operation.
• Developing a hernia in the scar.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Acute kidney injury.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19. (coronavirus) symptoms for at least 7 weeks before the operation.
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Difficulty passing urine. You may need a catheter (tube) in your bladder for 1 to 2 days.

Specific complications of this operation

• Anastomotic leak. This is a serious complication. You will likely need another operation and may need to have another stoma formed.
• Bowel obstruction caused by the joint swelling or scar tissue (adhesions) inside your abdomen.
• Continued bowel paralysis (ileus), where your bowel stops working for more than a few days, causing you to become bloated and to be sick.
• Diarrhoea.
• Developing an abnormal connection (fistula) between your bowel and your skin.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You may be able to go home the same day, however your doctor may recommend that you stay in hospital a little longer.

You should feel strong enough to return to normal activities within a few weeks of going home.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery. You will be followed up as planned after your original operation.

Summary

Surgery to join the two ends of your bowel back together should allow you to open your bowels in the normal way. You will no longer need a stoma bag.

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