When your surgeon discusses the need for you to have a stoma surgery, they should give you information on how to make contact with your Stomal Therapy Nurse. The first visit with your Stomal Therapy Nurse will provide you with information on living with a stoma and give you support in the lead up to your surgery. The Stomal Therapy Nurse will usually arrange to see you just before your scheduled operation, to “site” your stoma. This means the Stomal Therapy Nurse will look at your abdomen and discuss where the stoma will be best located. Siting a stoma may be difficult at times depending on the size and shape of your abdomen and your Stomal Therapy Nurse will guide you through this very important step. They will get you to lie, sit and stand so that they can see where the skin is mostly flat and smooth and also away from creases, scars, skin folds, etc.
The Stomal Therapy Nurse will also identify where the muscle lies beneath your skin, as the stoma is best brought through the muscle, for support. They will also discuss your regular choice of clothing to find the best spot for your stoma. Once chosen, there will be a X or a dot made on your abdomen to mark the spot. The surgeon will then know exactly where to create your stoma.
If your stoma has been done in an emergency situation, with little time for usual preparation, the surgeon will often make the decision on the position of your stoma during the operation. There may not have been time for your Stomal Therapy Nurse to do the siting of your stoma.