This topic revolves around a young person who is considering a surgical change from a transverse loop colostomy to an end colostomy at the sigmoid colon using a procedure known as Hartmann’s. The goal is to make the stoma easier to manage and better positioned under clothing. However, there are concerns about the risks involved, including mortality rates and the choice between open and laparoscopic surgery. Here are some insights and advice shared by others:

1. Understanding a Hartmann’s Pouch:
- The Hartmann’s procedure involves creating an end colostomy in the sigmoid colon while sealing off the downstream colon and rectum internally. This setup allows for the possibility of reconnection in the future.
- For more detailed information on the technique and potential complications, you can explore resources like ostomates.org, the Atlas of Pelvic Surgery, and studies on ScienceDirect.

2. Open vs. Laparoscopic Approach:
- Some suggest opting for an open surgery (laparotomy) and emphasize the importance of finding a highly skilled colorectal surgeon, even if it means traveling.
- There is concern that a laparoscopic surgeon who is not a colorectal specialist might not achieve the same results as an experienced colorectal surgeon.

3. Real-life Experiences with Blind Rectal Stumps:
- One person shared their experience of having issues with a loop colostomy, which led to a temporary sigmoid colostomy. After reversal, they experienced rectal pain and eventually required a permanent descending colostomy with a rectal stump.
- Managing the rectal stump involves regular digital rectal exams every 3–6 months, annual MRIs, and using steroid suppositories during episodes of radiation proctitis. Regular check-ups can help detect any polyps or inflammation early.

4. General Support:
- Offers of support through phone or email are available for reassurance and to help manage the challenges of caring for a newborn while dealing with an ostomy.