The Conseal Continent Colostomy Appliance

The concept of a continent stoma is an attractive one. This has been achieved with varying success for ileostomies made with a Koch pouch but not for colostomies. Permanent ileostomies, and to a proportionally lesser extent colostomies also, are becoming increasingly rare following increased expertise in sphincter saving operations, mucosal proctectomy and the success of the Jand W-ileoanal pouches. The number of permanent colostomies, particularly among older patients, is still substantial in each general surgeon's practice. To them should be added the patients undergoing an emergency Hartmann's procedure who may wait several months before colostomy closure. This latter operation is often difficult and the decision to proceed may be avoided by patient, surgeon or both. In the United Kingdom patients with an end, left-iliac fossa