For the last decade, most of the patients who need colectomy have been reconnected by an ileoanal anastomosis, usually with a small reservoir pouch. Some of these patients have unacceptable diarrhea and incontinence and require an ileostomy for control. Other colectomy patients had an ileostomy as the first procedure. A standard ileostomy requires wearing an external bag and has all the social and medical problems of wearing a permanent appliance.

In the continent ileostomy operation, an intestinal reservoir and valve are made of small intestine. This reservoir connects to the abdominal wall skin by a small flat stoma. No external bag or appliance is needed. The patient empties the reservoir two to four times a day by inserting a drainage catheter. This operation has the medical advantages of improving absorption, eliminating skin irritation, and preventing ileostomy prolapse, stricture, and hernia. It has the lifestyle advantages of eliminating the external bag, unexpected leaks, embarrassing noise and gas, and allows full participation in all athletic and social activities. This operation was designed by a surgeon named Nells Koch and is often called a Koch pouch.

on September 21 2002 01:00:32 ·