Portion of the Op Report
I incised the skin surrounding the ileostomy and carried this down to the fascia. The surrounding bowel was freed underlying the fascias. There were a fair amount of adhesions. In doing this, I made a small enterotomy in the distal limb. As this was very near to the prior anastomosis, and it was small area, I chose to repair it. The area was repaired with a running a 3-9 Vicryl suture. Interrupted 3-0 Lembert sutures were places over this. Both limbs of the ileostomy were then freed. I reinspected to assure there are no other injuries. I trimmed the skin from the edges of the bowe. I then reanastomosed the 2 ends in a hand sewn end-to-end fashion. Over layer posteriorly was completed with 3-0 silk sutures and a running layer of 3-0 Vicryl suture was completed. On the anterior layer, I placed interrupted 3-0 silk Lembert sutures. Ath the completion the anastomorisi, there is a patient opening with no bleeding. There is no obvious leak or any other problems. I re-inspected the areas ot the enterotomy distal to this. It was intact without evidence of any leakage. I irrgiated the wound with several 100ml saline. There is no bleeding. The bowel was replaced into the abdomen.