Background
The gross dilatation encountered frequently during emergency surgery for bowel obstruction, especially when colonic, can present a hindrance to safe mobilisation and progression. We describe an established technique to effectively decompress gaseous distension. Although employed by many surgeons, this has not to our knowledge been reported in the English literature, warranting formal reiteration.
Technique
With its plunger removed, a 10ml syringe is inserted into a 21G (green) needle and the sucker is detached temporarily from the suction tubing. The free end of the suction tube is then slid into the empty barrel of the syringe; the negative pressure exerted is sufficient to keep the apparatus united. The needle is passed through the serosa of the obstructed bowel and traversed 1–2 cm submucosally, before being directed through the mucosa and into the dilated lumen. Decompression of the gaseous component is gradually achieved before decannulation leaves a small, ‘self-sealing’ defect in the bowel wall (Fig 1).
Figure 1. Decompression of obstructed bowel using the needle, syringe barrel and suction tubing assembly.
Discussion
This frequently employed, simple technique provides effective decompression, particularly of the gaseous component during emergency surgery for obstruction, rendering safer and easier manipulation of the bowel.