The Kock pouch and Barnet Continent Intestinal Reservoir (BCIR) are similar solutions to the problems with a traditional ileostomy. In fact, the BCIR actually refers to specific improvements made to the Kock pouch by Dr. Barnett, reports BCIR History. While some ileostomy risks and complications may remain with the BCIR, its key differences from the Kock pouch reduce the incidence of these risks and problems.
Fistulas are one of the most problematic risks and complications of a Kock pouch. When a fistula develops, a person is more likely to suffer from leakage, septicemia and failure of the pouch, and the number of layout of the sutures to create the pouch is directly related to the risk for developing fistulas. Unfortunately, the Kock pouch uses three different suture lines to create a triangular pouch, dramatically increasing risk for complications.
Unlike the Kock pouch, the BCIR uses a single, longitudinal suture line to create a lateral pouch. This pouch is oriented similar to how a pillow would lie on the bed. As a result, the incidence of the pouch rupturing or developing fistulas is reduced.
The BCIR also doubles the protection of the pouch by using a portion of the intestine and turning it in on itself. In other words, the surgeon creates a double-layered pouch, which helps to ensure the pouch retains its shape and function. Furthermore, this creates a self-sealing valve to prevent peristalsis of the intestines from pushing the contents of the pouch into the abdominal cavity or through the stoma.
The BCIR goes a step beyond the double-layered protection by using the intestines to create a collar around the BCIR, which tightens as the pouch fills. When the pouch has reached capacity, the collar prevents the pouch from rupturing due to additional pressure, and it serves a secondary purpose by reducing the incidence of leakage from the stoma. This also helps those who need an ileostomy retain quality of life.
Modern ileostomy alternatives are drastically different from traditional treatments, but the BCIR is also different from the Kock pouch. By understanding these differences, you can be better prepared for how an internal ileostomy reservoir, including the BCIR, can help you live a healthier, fulfilling life. To learn more about the BCIR, schedule your appointment with Dr. Don Schiller today.