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Koch Pouch or BCIR (Barnett Continent Intestinal Reservoir)

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Posted 8/28/2008 2:31 AM (GMT 0)
Hi Everyone!

 

I just came back from the Cleveland Clinic with bad news. I learned that I probably will not be able to have an ileostomy reversal.  My doctor told me that my rectovaginal fistula is not healing because I have too much scar tissue.  Because of all the surgeries I've had I probably will not have enough muscle to keep myself continent as well.  I'm looking into either a Koch Pouch or the Barnett pouch.  Does anyone have one of these or know much about them?  I've researched the Barnett Pouch which is supposed to be a revised Koch (or Kock) Pouch.  The Barnett or BCIR has a website at BCIRostomy.com.  It sounds very interesting.  I'm not sure if The Palms of Pasedena Hospital in St. Petersburg, FL is the only place that performs the BCIR, so if anyone knows, please let me know.  I did learn that both the Koch Pouch and BCIR requires your colon and rectum need to be removed.  That's pretty drastic.  Also, your hospital stay is 3 weeks with 2 weeks of TPN.  Yikes!  I've been through the TPN before and 2 weeks of hospital stay, so I think I can handle it.

 

I'd love to learn about peoples experiences.  I think if I have to live with an ostomy forever, I'd rather try for an internal one such as these two then to have an external one forever. 

 

Please let me know your thoughts.

 

I was pretty shook up today with the news.

 

Thanks!  Mary

 

Post Edited (Ohio43) : 8/27/2008 8:35:11 PM (GMT-6)

Posted 8/28/2008 3:10 AM (GMT 0)
well i looked into those too, and i learned that they sound really great, but tehy are only performed in like two hosptials in the united states, and only about 500 or so have been performed (at least as of about two years ago) and the problem with them is since they are trademarked surgeries, or something like that, that part doesnt'make much sense to me. but anyway, because of that only the hospital that put it in will work onit. so you have to go back to there if you ever have a problem with it. Which if you live there then that's not a big deal.
I just decided to go with the perm ostomy because i didnt want to deal with anything going wrong, lol.
Posted 8/28/2008 1:05 PM (GMT 0)
No matter which surgery you choose for UC you are going to lose both your colon and rectum so don't worry about that.

The BCIR is a proprietary surgery and only practiced at 2 hospitals, one in Florida and one in Los Angeles. At least this was true a few years ago. The Kock pouch is performed in many more hosptials around the country including the Cleveland Clinic. In my opinion it makes it a more viable option over the BCIR. Both surgeries are the same except the BCIR's valve is proprietary- I think. You can meet fellow kpouchers at www.j-pouch.org and go to the kpouch discussion thread. There are some kpouchers on that site who have had theirs for 30 years so they have good knowledge and experience to share. Even the owner of the jpouch.org website has a kpouch after losing his jpouch.

All the kpouchers I have met are very happy with their outcome. I am not sure if that story about TPN at surgery, or the length of hospital stay is correct but they can answer your questions. If you want to meet people with BCIRS go to www.bcirostomy.org and look for their discussion board.

Remember, no surgery is perfect! The jpouch, the perm ostomy, the BCIR, and the kpouch all have pros and cons. You need to determine which surgery best fits your lifestyle and is the decision you can support 100%.

Sue
Posted 8/28/2008 10:58 PM (GMT 0)
I'm really sorry to hear you didn't have good news. I can't imagine how disappointing that must have been.


I've decided that when I have j-pouch surgery someday, if it fails I will go for the BCIR after that before reverting to a permanent ostomy. However, I live about 10 minutes away from the hospital in St Pete, Florida that performs these surgeries so travel wouldn't be an issue. I would think for someone that lives far away it might be better to go with something like the K-Pouch because if anything went wrong, it would be more convenient to treat. However only you can make the decision on what surgery would be best for you and whether or not the convenience is an issue. I would say just research them both and go with whatever option you're most comfortable with!

Good luck, I hope you find relief soon.

Posted 8/28/2008 11:29 PM (GMT 0)
Thanks everyone for your feedback. Every bit helps. I will do just that with giving it all a lot of thought. I'm going to take about a year to get myself in better health - losing weight, exercising, lowering my cholesterol, etc. Last year when I went through several surgeries and was on TPN, I lost 17 pounds, which I've put back on. Cleveland Clinic told me they wouldn't give me a K-Pouch until I lose 50 lbs. So, I'll lose the weight. It will give me a goal even if I don't opt for a K-Pouch. I've lived with the ostomy for over a year now. I can deal with it.

I'm going to go on the J-Pouch site. Unfortunately, the J-Pouch is not an option for me since I have a damaged anal sphincter. Very little muscle control now.

Again thanks for the advice and encouragement. I joined the local Ostomy Association. I just have to make time to go to a meeting.

Mary
Posted 7/4/2014 6:05 PM (GMT 0)
Hi there. I'd sure like an update on how K Pouch and BCIR surgical decisions have gone for those considering them on this thread. It's 2014 and looks like the threads I'm finding are quite old on the subjects, but I'll keep looking. my email is [email protected] Good luck.
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