Transcribed from Video Above featuring Dr. Schiller:
Hello. I’m Dr. Don Shiller, and I’m speaking with you here at Olympia Medical Center in Los Angeles, California. I’m going to talk about the three surgical options available if you need to have your large intestine removed. The usual conditions that lead to that type of surgery are ulcerative colitis and familial polyposis. If you need to have your large intestine and rectum removed to cure these conditions, there are three options available. The first option is removing the entire colon and rectum and doing a conventional ileostomy. The Brooke ileostomy, named after Dr. Brooke from the 1950s, requires wearing an external appliance because the small intestine is a continuous flow system. It always drains waste. A second option is the ileo-anal J pouch. In this operation, the colon is removed, the large intestine, and the rectum, but the lowest part of the rectum and the anal sphincters are left in place. A pouch is created from the small intestine and connected to the anal canal, and that enables the person to have normal bowel movements, going to the bathroom in the normal way, without equipment.
The J Pouch procedure is an excellent operation, but fails from five to fifteen percent of the time, and some patients are not candidates for it. And that leaves the third option, which has been available since the late 1960s or early 1970s. That’s an operation where we remove the diseased colon and rectum, and create an internal type of ileostomy, called a continent ileostomy. This is a pouch made from the intestine, with a valve made from the intestine, so no waste or gas comes out of your stoma until you sit down and put a catheter in and drain the waste. The original pouch was the Kock pouch, and modifications have been made to improve the outcomes. I have been performing the Barnett-type of Kock pouch since 1989, the BCIR or Barnett Continent Intestinal Reservoir, and we’ll learn more about that in our next video. Thanks for your attention.