What is a well-placed stoma

omrhill
omrhill Member Posts: 125
in Colorectal Cancer #1
Good morning, all. I've been doing some reading and planning for my surgery on August 2nd (Stage III rectal, post chemo/radiation). I'm hoping the treatments have been so successful that I won't need a temporary colostomy, but I know I probably will so I've been reading up on them to be prepared. Here's a question that needs an experienced answer: everyone says "make sure it's a well-placed stoma" but they never tell me what the considerations are. What factors should I consider for a well-placed stoma? (Note - I'll see my surgeon two weeks pre-op for a planning session, so I'll ask about a stoma nurse then.)

Thanks!
Robin

Comments

  • Kenny H.
    Kenny H. Member Posts: 502 Member
    #2
    Mine is to my left of belly
    Mine is to my left of belly button about 2in. Slightly downward. But mines permanant, seems to be doing well in that location. Use 2-piece holister system. Like them the best.
  • Lovekitties
    Lovekitties Member Posts: 3,364 Member
    #3
    Hi Robin
    First let me compliment you on your 'just in case' research. Many don't have that opportunity and have to come to terms with it after the fact.

    As to the question of what is a well placed stoma. I would say for a colostomy it is approx. 2 inches to the patient's left of mid-line and 2 inches down, which keeps it out of the natural belt line. That being said it might have to be relocated based on what is found at surgery or other anatomical issues. Whatever is marked by the stoma nurse should be optimum based on what is known before surgery.

    Certainly the placement of a stoma for an ilio would be different.

    Pre-planning with a stoma nurse is the key to hopefully getting a 'well placed stoma'.

    Best wishes for successful surgery and recovery,

    Marie who loves kitties
  • John23
    John23 Member Posts: 2,122 Member
    #4
    Hi Robin!

    You can read some info on my "blog", here on this forum:
    http://csn.cancer.org/user/75969/view/blog

    The idea of a stoma being "well placed", is to have it where it
    easiest to maintain, and where it won't interfere with the clothes
    you normally wear and how you wear them.

    There is a "4x4" rule that most surgeons will use when preoperative
    planning did not take place. The "4x4" indicates that the stoma
    will be 4" to the side of the naval, and 4" below the belt line.

    It's usually preferable to have it below your waistline, so you can
    continue wearing what you presently wear. If it's too high, you'll
    have problems with both outer wear and underwear. Too low,
    and you'll be tripping over it. (just kidding)

    If it's an Ileostomy, it's best to have it placed so the pouch will
    be aiming down the front of your leg. Sitting on the toilet, the
    pouch will fall naturally between your legs for emptying.

    The stoma nurse (WOCN) can be of great assistance in helping
    with the placement. Some even place an appliance on your skin
    at the location that's been marked. They'll fill it with some sort of
    stuff (usually applesauce) (seriously) and let you wear it to see how
    it feels. (It feels like a bag of applesauce! what else would it feel like?)

    Having spots marked for both a Colostomy and an Ileostomy
    isn't a bad idea. All too often a surgeon will find some reason for
    the need for something other that what was originally planned!
    It's happened to me twice, so I feel it was worth mentioning.
    Surprises are nice, except when it's a pregnancy or an ostomy;
    both change your life.... ya'know?

    Best wishes,

    John
  • omrhill
    omrhill Member Posts: 125
    #5
    John23 said:

    Hi Robin!

    You can read some info on my "blog", here on this forum:
    http://csn.cancer.org/user/75969/view/blog

    The idea of a stoma being "well placed", is to have it where it
    easiest to maintain, and where it won't interfere with the clothes
    you normally wear and how you wear them.

    There is a "4x4" rule that most surgeons will use when preoperative
    planning did not take place. The "4x4" indicates that the stoma
    will be 4" to the side of the naval, and 4" below the belt line.

    It's usually preferable to have it below your waistline, so you can
    continue wearing what you presently wear. If it's too high, you'll
    have problems with both outer wear and underwear. Too low,
    and you'll be tripping over it. (just kidding)

    If it's an Ileostomy, it's best to have it placed so the pouch will
    be aiming down the front of your leg. Sitting on the toilet, the
    pouch will fall naturally between your legs for emptying.

    The stoma nurse (WOCN) can be of great assistance in helping
    with the placement. Some even place an appliance on your skin
    at the location that's been marked. They'll fill it with some sort of
    stuff (usually applesauce) (seriously) and let you wear it to see how
    it feels. (It feels like a bag of applesauce! what else would it feel like?)

    Having spots marked for both a Colostomy and an Ileostomy
    isn't a bad idea. All too often a surgeon will find some reason for
    the need for something other that what was originally planned!
    It's happened to me twice, so I feel it was worth mentioning.
    Surprises are nice, except when it's a pregnancy or an ostomy;
    both change your life.... ya'know?

    Best wishes,

    John

    Applesauce? Really? Too
    Applesauce? Really? Too funny. (But someone seems like the perfect filler...). Thanks!
  • RickMurtagh
    RickMurtagh Member Posts: 587 Member
    #6
    The perfectly placed stoma
    The perfectly placed stoma is on someone else.
  • omrhill
    omrhill Member Posts: 125
    #7
    RickMurtagh said:

    The perfectly placed stoma
    The perfectly placed stoma is on someone else.

    We've got a bunch of
    We've got a bunch of comedians on here! Very funny. And very true. :-)
  • dmj101
    dmj101 Member Posts: 527 Member
    #8
    everyone is correct...
    mine
    everyone is correct...
    mine is a permanent stoma.. to left of belly button@ 2 inched..
    about the size of a quarter.. little smaller.. sort looks like a rosebud...not at all as ugly as the pics in the sites you will see.. I would take a pic of it if I didn't think that was obscene.. I am really happy with it..
    works well with Holister 2 piece system..
    Though I think if it was slightly lower it would be prefect..
  • omrhill
    omrhill Member Posts: 125
    #9
    thanks!
    The thought of a colostomy is not quite so awful the more I learn. I had been reading about one piece vs two piece zystems so that recommendation is helpful. John - your blog on stoma care is a huge help.
    Who would have know i'd ever be having this conversation. Damn cancer.
    Robin
  • dmj101
    dmj101 Member Posts: 527 Member
    #10
    omrhill said:

    thanks!
    The thought of a colostomy is not quite so awful the more I learn. I had been reading about one piece vs two piece zystems so that recommendation is helpful. John - your blog on stoma care is a huge help.
    Who would have know i'd ever be having this conversation. Damn cancer.
    Robin

    you tube
    I know.. it sounds silly..
    but there are some real life people discussing care for their stoma's on you tube.. search colostomy .. you will be delighted to see young people showing how they care for themselves. I found them really helpful and they filled me with hope that this was manageable. they may not be cancer but colostomies are done for more than cancer..
    their comments and videos are much easier to follow than any of the manufacturers sites.
    Good luck to you..
    PM if you need any personal guidances..
    Donna

Discussion Boards