This topic is about understanding the differences and expectations when considering surgery to correct a stoma that isn't functioning well. The options are either a stoma revision or a re-site surgery. Here's what you need to know:

- **Revision vs. Re-site**:
- A revision involves reshaping the existing stoma by bringing more bowel through the current opening and stitching it to protrude correctly. This is usually limited to the stoma area.
- A re-site means closing the old stoma and creating a new opening elsewhere, often on the opposite side or higher up, and bringing the bowel through this new hole.

- **Surgical Incisions**:
- Some people only needed a peri-stomal incision, which means the midline abdominal incision wasn't reopened, leading to a quicker recovery.
- Others had to have the original vertical incision reopened or extended, especially if there were strictures, adhesions, or significant scar tissue. This was more painful but still easier than the initial ileostomy surgery.
- Using the rectus muscle to pull the stoma through is important to prevent prolapse and retraction.

- **Recovery Experiences**:
- Hospital stays varied from 5 to 10 days, with most people experiencing a quicker recovery than their first surgery.
- Some had a very fast recovery, especially if only a minor revision was needed.
- Pain management, such as using an epidural, significantly reduced discomfort for some, while others found recovery tougher without it.
- Once the stoma was properly formed, pouch wear-time improved significantly, lasting 4 to 8 days without leaks.
- People generally returned to normal food intake and activities after a successful revision or re-site.

- **Benefits**:
- Many experienced a reduction in leaks, skin irritation, and pain.
- Some could switch to using flat barriers instead of convex ones, or vice versa, depending on the new stoma's position.
- Appliance changes became less frequent, and wear-times were longer.
- Overall, there was an improvement in quality of life and fewer doctor visits or need for medication.

- **Surgical Tips & Considerations**:
- It's advisable to choose an experienced colorectal surgeon over a general surgeon.
- Proper pre-operative siting of the stoma, such as above the belt line and through the rectus muscle, is crucial.
- Bowel preparation is still necessary and was noted as the most unpleasant part for some.
- Acting promptly is important, as delaying a revision can worsen strictures and increase the risk of bowel rupture.
- The "Vulcan Technique" was mentioned as a reference for ileostomy re-site, though details weren't provided.