Transverse colon or sigmoid colon
may be used
Indications
Hartmann’s
procedure.bmp)
.bmp)
Indications
·
Distal obstruction – due to carcinoma
·
Protection of low rectal anastomosis
·
High anal fistula
Procedure
- Location
– avoid skin creases. Not too close to the umbilicus, over the lateral
part of the rectus abdominis muscle (mid way between the umbilicus and the
costal margin)
- Incision
– transverse, 5-10cm long. Divide
the anterior and posterior rectus sheaths and the rectus muscle in the
line of the incision.
- Find
the colon – taenia coli+, omentum is attached to it.
- Technique – select the colon as far to the right as possible. Pull it out gently and place it with out tension. Separate the omentum and make an opening in the mesentery close to the bowel wall. Pass a rubber tube through the opening made. This tube may be passed sub cutaneously and brought out through separate stab incisions. Open the colon with an incision across it at the apex of the loop. Clean the contents. Turn back the edge of the opening and suture the full thickness of the bowel to the skin with interrupted absorbable sutures. Ensure that the opening in the abdominal wall is not too tight,
Indication
·
Obstructed, perforated sigmoid carcinoma
·
Perforated diverticular disease
Technique
- Laparotomy – peritoneal lava
- Mobilize the diseased colon
- Ligate the sigmoid vessels
- Apply non crushing bowel clamps (two each to the proximal and distal end of the segment to be divided)
- Divide the bowel between clamps
- Close the distal end – with one or two layers of sutures
- Bring out the proximal end as an end colostomy – through a separate opening (mid way between umbilicus and the anterior superior iliac spine)
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ReplyDeleteI was diagnose April 17,2015 and find out I'm HIV positive.I was scared because there is no cure for HIV/AIDS but today some people still don't believe that there is cure for HIV, it can only be cured through Africans root and herbs,and our doctor's here in USA few of them know about the African herbal medicine can cure Hiv but they chooses to hide it from us just to make a sales of medical expertise. I did a research online finding way to get rid of my disease,I saw a comment about a herbal doctor on internet Name Dr itua ,who has cured several disease with his powerful herbal medicine, I contacted him on whats-app, chat with him explain my self to him.He said he can cure hiv perfectly well , he gave me his request which i send to him. within 5 days he sent me the herbal medicine through ups courier delivering service And told me how to take the medicine for 2 weeks to get cured,I did for 2 weeks, within this 7 days i notice a very big change in my health and i new some thing great has happened then i went to confirm my result after finishing the herbal medicine for two weeks it was absolutely negative.The doctor who new i was hiv positive was asking me how come i am negative, what did it took to get cure and were did i get this medicine from and how did i get rid of it I told him every thing about the herbal medicine that cure me. imagine doctor telling me not to let anyone know about it,I wasn't shock though i knew they know about the herbal cure but chose to hide it in other to make sales on medicals expertise,if you are HIV positive Or other disease such as,Sickle Cell,Cancer,Hiv,Herpes,Shingles, Hepatitis B,Liver Inflammatory,Diabetes,Fibroid,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease,Cushing’s disease,Heart failure,Multiple Sclerosis ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease, Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Syndrome Fibrodysplasia Ossificans ProgresS sclerosis,Seizures,Adrenocortical carcinoma.Asthma,Allergic diseases,,Copd,Glaucoma., Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.Autism,Fibromyalgia,Fluoroquinolone Toxicity,Dementia.,Lyme Disease,,Non Hodgkin Lymphoma,Skin Cancer,Uterine Cancer,Prostate Cancer Dercum,Lupus,Hpv,Weak Erection,Infertility,fibromyalgia,Chronic Diarrhea,Get Your Ex Back,Als,SYPHILIS,Colo-Rectal Cancer,Blood Cancer,Breast CANCER,Lung Cancer,Prostate Cancer,Autism,Brain Cancer,Genetic disease,Epilepsy, Parkinson's disease,.. please contact my savior drituaherbalcenter@gmail.com or WHATSAPP number +2348149277967..
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