This topic is about considering whether a two-stage surgical approach is necessary for an ostomy reversal. The discussion revolves around the experiences and advice of individuals who have faced similar decisions.

Here's a breakdown of the situation and some helpful insights:

- After a clear colonoscopy, a gastroenterologist suggested that a colostomy reversal could be done with minimal risk. However, a colorectal surgeon recommended a two-stage approach:
1. First, reconnect the colon and create a temporary ileostomy for 8–12 weeks to protect the new connection.
2. Then, perform a second surgery to close the ileostomy.

- The person considering surgery is concerned because they feel their medical history wasn't fully reviewed. They worry about:
- Undergoing two separate operations.
- The risk of ending up with a permanent ileostomy if complications arise.
- Their ability to manage a sigmoid colostomy better than an ileostomy.

- They are seeking advice from others who have experienced similar two-stage reversals and are questioning if both surgeries are truly necessary.

Additional insights and advice include:

- The two-stage approach is seen as a cautious method. By doing the reconnection first and using a temporary ileostomy, the risk of complications like an anastomotic leak is reduced.

- The decision is very personal and should consider one's tolerance for risk, overall health, and quality of life.

- Many recommend getting a second opinion from another colorectal surgeon to explore all options.

- There is a success story of a single-stage procedure: One person had a successful one-time colostomy reversal after a ruptured diverticulitis. Although the surgery started as a laparoscopy, it was converted to an open procedure due to adhesions. The anastomosis was hand-sutured, and its integrity was confirmed with a saline/air leak test. A Penrose drain was used for three days, and the person was discharged three days post-op, achieving soft-formed stools within a week. This shows that single-stage procedures can be successful under favorable conditions.