Figure 1.

Surgical procedure. The photographic images show a distal colostomy operation. (a) The cecum is exteriorized after median laparotomy to identify the transverse colon. The transverse colon is pulled through a little incision in the right upper quadrant of the abdominal wall and stabilized by a small flexible tube passed through the mesocolon. (b) The cecum is transferred back into the peritoneal cavity and the laparotomy is closed in two layers. The flexible tube is sutured to the skin to avoid slipping of the exteriorized colon. The colon is opened by subtotal transection. (c) The afferent and efferent part of the colostomy are sutured to the skin, creating a blocking loop colostomy. (d) The blocking loop colostomy shows no signs of irritation after two months. (e) Graphical representation of the postoperative anatomy.