Stoma closure (restoring bowel continuity)

A stoma is an opening of the bowel onto the skin of the abdomen, allowing stools to drain into a bag. It is sometimes created temporarily: to protect a fragile join (after rectal surgery, for example), or after an emergency operation (peritonitis, obstruction, perforated diverticulitis). When the situation allows, it is closed to restore the normal digestive tract. Closing a loop ileostomy or loop colostomy is a short operation: the surgeon frees the bowel around the opening, joins the two segments and closes the abdominal wall. After a Hartmann's procedure (end colostomy with the rectum closed), reversal is a bigger operation: the rectum must be found and joined to the colon, often laparoscopically. Before closure, the team checks that the protected join has healed properly (contrast X-ray, endoscopy) and that the person is in good general health, usually after a few weeks to a few months. The surgeon also assesses how well the anal sphincter works. At Clinique Pasteur Tunis, the date of closure is set in consultation after these checks. The team supports the return of natural bowel function, with dietary advice for the first weeks.