Loop stomas continue to be a popular method of stoma formation for bowel diversions.  Internal fecal pouches have increased the number of loop ostomies used. Rods for loop stomas have changed little in the past two decades and present challenges to placing the pouch and obtaining an adequate barrier to the skin. In addition to the commercially made stoma loop rods WOCN’s and surgeons have tried to decrease these issues by using red rubber catheters or other types of tubing, typically sutured to the skin, leading to similar problems in creating barriers.     
                   At VUMC, Drs. Alan Herline, Paul Wise, and Roberta Muldoon created an “S” shaped loop rod using the stylet from an endotracheal tube.  The material is stiff enough to support the loop stoma yet flexible enough to allow a change in shape after it has been placed under the stoma.  This allows the WOCN to make minor changes in the shape and size for patient comfort or an alternate pouching system.  The “S” rod is turned to a vertical position for removal and placement of a barrier.  Once the barrier or pouch is in place the rod is then repositioned horizontally to support the stoma.  This ability to reposition the rod makes it easier for patients to learn how to change their pouching systems. Another advantage of the “S” rod is the ease of removal.  Rounding residents or physicians can remove the rod without the removing the pouching system.  The patient can easily remove the rod at home if it needs to stay in for several days after discharge.   We have found this “S” loop improves the ability to get a good barrier around the stoma thus reducing skin irritation and enhancing patient comfort.