The double-spouted loop ileostomy

Objective  A functional improvement to a conventional loop ileostomy is described with both proximal and distal limbs spouted reducing the number of patients with problematic ileostomies.
Method  The results of the National Prospective Audit of Stoma Complications for the hospital showed 14/15 of the traditional single loop ileostomies were identified as problematic. 21 patients were then studied prospectively, who underwent formation of a new type of loop stoma, in which both the proximal and distal limbs were spouted.
Results  In the group of 21 patients with a double spouted loop ileostomy 3/21 had a problematic stoma. The number of appliances needed was significantly less than the single spouted group. The number of home visits by the stoma nurse and outpatient visits to the stoma therapy team at the hospital were also significantly less in the double spouted group.
Conclusion  This modification of the loop ileostomy, with both the proximal and distal ends of the bowel spouted has several advantages. The danger of spouting the wrong limb is eliminated, it can be created very easily via a trephine technique and spouting the distal limb reduces the leakage of mucus under the flange of the stoma bag, reducing the problems of poor appliance adhesion.