Examples from the qualitative data representing the development of the overarching category theme ‘stoma snugness’
| Subtheme | Extract |
| Assessment of stoma snugness | Extract 1: ‘It is better to pull it through and think, “That is a bit snug.” Then making a bit of a nick in the posterior sheath to make it a bit wider or using your Langenbeck’s to sometimes just stretch it. That does vary between whether you do that sharp or blunt’. (HCP: BRI0022, surgeon, lower GI, RDE) Extract 2: ‘With the surgeons index finger he checks for snugness of the trephine. On deciding it is too tight he requests a langenbeck retractor and places it along side his finger, asking the SpR to hold it and retract. Using mackindo scissors he makes a further incision in the peritoneum. Consultant re-checks for snugness on either side of the stoma, checking from inside of the abdomen and outside’. (Observation CM: BRI0034, end ileostomy, converted laparoscopic to open, BRI) Extract 3: ‘The traditional has been one finger in, one finger in, and a bit of pulling and tearing and everything else’. (HCP: BRI0023, lower GI, RDE) |
| Mesentery stripping | Extract 4: ‘What you’re trying to avoid is stripping the mesentery off, cos if you strip the mesentery off the bowel it’s ischemic and it will go dusky and flat so you might create a bigger whole and then you’ve got a risk factor for parastomal hernia’. (HCP: BRI0036, surgeon, lower GI, BRI) Extract 5: ‘If the appendices epiploicae are large I'll remove them but I want it under no tension and subcuticular to extramucosal sutures with all the knots buried’. (HCP: BRI0015, surgeon, lower GI, RDE) |