This topic is about preparing for spinal surgery when you have an ileostomy. The person involved is understandably anxious because the surgery will take place inside the spinal cord, and they are looking for advice on how to manage their ileostomy during the procedure and recovery. Here are some helpful tips and insights:

1. The goal of the surgery is to preserve bladder function and avoid the need for a future urostomy. The ileostomy was necessary due to loss of colonic innervation from previous spinal damage.

2. The surgery is expected to last about 4 hours, with a total of 6 hours in the operating room. The person plans to inform the nurses to monitor and empty the pouch during the procedure.

3. For positioning while prone:
- Ask the anesthesiology or operating room team to place two pillows or rolled towels—one under the chest and one under the hips. This creates a "pocket" so the stoma and pouch can hang freely, preventing pressure and allowing output to flow.
- Ensure the staff understands that you cannot risk additional small-bowel damage and that they need to protect the stoma site.

4. For intra-operative pouch management:
- Request that the nursing staff keep an eye on the pouch during surgery and empty it if it begins to fill.

5. Advocacy:
- Clearly explain your ileostomy needs to all peri-operative personnel. Do not hesitate to speak up if any equipment, such as a postoperative brace, compromises your ostomy or comfort.