Intestinal transplantation may be performed as an isolated bowel transplant together with the liver as a combined small-bowel-intestinal transplant or as a multivisceral transplant procedure. The common element of these procedures is transplantation of the jejunoileum, with or without other organs. Soon after transplantation, most surgeons create an ileostomy to allow easy endoscopic surveillance of the graft for abnormalities. We prefer a technique where the distal end of the graft is brought out as a stoma wherever it is best situated; the ileum, however, is anastomosed with the remaining colon some 10-20 cm before its entrance into the abdominal wall. Gastrointestinal continuity is restored simply by stapling and transecting this chimney just distally to the anastomosis, which can then be used as a sentinel grafted tissue. We call this the "Innsbruck stoma."
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