Technical Notes and Tips: The Spouted Stoma

I was surprised at the article and only comment because it was invited by the editor. In paediatric practice, colostomies are frequently spouted and have been for many years; this is not a new technique. Can I describe the same technique for the jejunum and put my name to it? Interestingly, in sick premature babies, the bowel may not tolerate evertion at the time of surgery and one can leave the small or large bowel to evert itself to form a nice spout fixing only the bowel to the fascia a centimetre or so from its distal end. An interesting question in relation to spouted urostomies is why the skin grows up to the top of the spout, a phenomenon not seen with the intestine.