Clinical Challenges in Colorectal Surgery: Managing the Tough Stoma

This episode offers a practical, case-based approach to one of the most common intraoperative challenges in GI surgery: constructing a stoma that just won't cooperate. The discussion covers preoperative marking and stoma siting in the obese and non-elective patient, technical maneuvers to gain length and reduce tension on the stoma, strategies for the foreshortened small bowel mesentery, and considerations for maturing a stoma in a massively dilated, thick-walled colon. Join Drs. Elissa Dabaghi, Jared Hendren, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss this clinical challenge in colorectal surgery.Hosts: ·      Elissa Dabaghi, MD, Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio·      Jared Hendren, MD, Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio·      Joseph Trunzo, MD, Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, X/Twitter @joseph_trunzo·      Ajaratu Keshinro, MD, Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, X/Twitter- @AJKesh·      David Rosen, MD, Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, X/Twitter- @davidrrosenmdLearning Objectives: By the end of this episode, listeners will be able to:1.     Describe preoperative marking strategies and intraoperative technical adaptations for stoma siting and construction in obese and non-elective patients.2.     Apply strategies for managing a foreshortened small bowel mesentery when constructing an end or loop ileostomy.3.     Recognize technical considerations for maturing a stoma in a massively dilated, thick-walled colon and identify associated long-term risksSponsor Disclaimer: Visit https://www.goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content.Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Coures: <a href="https://