Colotomy with minimum resection for advanced irreducible intussusception.

A patient having a resection anastomosis for advanced (apex up to midsigmoid or beyond) irreducible intussusception would end up having an ileosigmoid or ileorectal anastomosis. The outer layer of the intussusception is almost never gangrenious; this outer layer can be saved by colotomy with minimum resection. The procedure consists of a colotomy made on the outer tube just proximal to the apex, and the apex is delivered and amputated. The inner tube is pulled out, the intermediate tube is reduced, trimming off the margins of both ends and anastomosis is made between ileum and ascending colon. This method offers the advantage of conserving a major part of the large bowel.