Excerpt from The Canadian Medical Review, Vol. 7: June, 1898
First. It is easier. Where the colon is distended the lumbar opera tion is an easy one, but where the bowel is flaccid and lies deeply in a fat patient it is one of the most difficult operations in surgery. In doing inguinal colotomy the soft parts are much thinner, and after opening the peritoneum the colon is much more accessible. In a stout patient the soft parts are easier to divide, and the resulting wound less deep and more readily dealt with than one in the loin; the bowel is more easily reached and with less disturbance of deep lying soft parts. There is no risk of opening small intestine or of failing through abnormality of the colon.
Secondly. The peritoneum being Opened, the site and extent of disease can be ascertained.
Thirdly. The shallower wound makes it much easier to draw out the intestine and make a satisfactory angle and spur, or to perform colectomy.
Fourthly. The position of the anus is more convenient for the needful attention.
The second advantage mentioned is very important, as in cases of annular or limited disease of the sigmoid the growth may be removed, and when uncertain as to the situation of the disease the surgeon can make sure of opening the bowel above it.
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