OPERATION: Laparotomy, Resection of Ileocolic Anastomosis and End Ileostomy
ANAESTHETIC: General anaesthesia
INCISION: Midline.
FINDINGS: Defect in anastomotic staple line. Contained leak with minimal contamination.
PROCEDURE:
Anastomosis mobilised out of abdomen.
GIA stapler x2 to staple bowel off either side of anastomosis.
Ligasure to mesentery. PDS to colonic staple line.
End ileostomy fashioned in right iliac fossa at premarked site.
Washout with 4L fluid. Drain placed to pelvis.
CLOSURE:
Mass closure with looped PDS. Collatamp to wound.
Clips to skin. 40ml levobupivacaine infiltrated.
POST-OPERATIVE INSTRUCTIONS:
Nasogastric tube on free drainage for 24 hours.
Continue Dalteparin with extended prophylaxis on discharge.
Continue antibiotics for 5 days. Leave drain until further instruction.