Reversal of a Diversion Loop Ileostomy in a Patient with a Prior Gracilis Transposition Flap for Rectovaginal Fistula Due to Crohn’s Disease

1. Introduction

2. Mobilization of Loop Ileostomy and Afferent and Efferent Limbs

3. Betadine Under Pressure to Test for any Seromyotomies

4. Dissection Through Mesentery

5. Bowel Divisions to Resect Ileostomy

6. Stapled Side-to-Side Anastomosis

1. Excise Tips of Staple Lines
2. Perform Anastomosis
3. Remove Corners for Rectangular Closure
4. Hemostasis

7. Apical Line Closure with GIA 100 Stapler

1. Hemostasis
2. Cross-Stitches

8. Reposition Small Bowel into Abdomen

9. Fascial Closure with Interrupted PDS

10. Excision of any Hernia Sac

11. Closure