Diverting ileostomy set removable without laparotomy--feasibility study.

We constructed an ileostomy set that creates a diverting ileostomy not requiring surgery for closure. The set has two primary components: a double-balloon drainage catheter and a plastic holder. The plastic holder has a rotary component that is used to tighten a percutaneosly placed lasso-loop stitch and purse the enterotomy after the drainage catheter is removed. We tested the ileostomy set in 10 experimental pigs. The drainage catheter was introduced transcecally into the terminal ileum behind Bauhin's valve, and the balloon was inflated. Three to seven days later the drainage catheter was removed, and the cecotomy was closed by percutaneous tightening of the lasso-loop stitch. One week later each animal underwent relaparotomy, and we examined the abdominal cavity for peritonitis. An ileocecal resection was performed, and specimens were collected and evaluated microscopically to ensure that the catheter had not damaged the intestinal wall. The only change noted in the terminal ileum was submucosa lymphatic tissue hyperplasia. No intestinal leaks occurred, and percutaneous enterotomy closure was successful.