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Understanding BCIR: The New and Improved Kock Pouch

June 29, 2016  ·  By: Dr. Don Schiller

The Barnett Continent Intestinal Reservoir, or BCIR, is a revision to the Kock pouch that made several improvements on its design. If you are exploring ostomy options, or if you have a failed or troublesome ostomy, you may benefit from this procedure.

About the Kock Pouch

At the time it was created, the Kock pouch represented a significant advancement for patients requiring an ostomy. This pouch was created from the patients’ own intestines. Once in place, the pouch must be emptied several times per day using a silicone catheter. When the pouch is not being emptied, patients had to place an absorbent pad over the stoma in order to collect the mucus produced by the intestines.

Unfortunately, this pouch isn’t always successful. Patients with Kock pouch often experience complications, including leakage of waste and problems with catheter insertion.

How BCIR Improved the Kock Pouch

BCIR is a procedure that was developed by Dr. William Barnett, a surgeon who dedicated part of his career to improving the design of the Kock pouch. BCIR makes three primary changes to the Kock pouch.

  1. A change to the incision. – BCIR utilizes only one midline incision, which reduces the risk of fistulas developing at the surgical site.
  2. The nipple valve. – Rather than utilizing a traditional open stoma, BCIR involves the creation of a “nipple valve” from a small portion of the patient’s own intestine. This reduces the risk of leaks and prolapse.
  3. The living collar. – With BCIR, the surgeon wraps a part of the intestine around the base of the valve, further reducing the risk of leaks.

Do I Need a BCIR?

If you have been advised to have an ostomy procedure, or if you are living with a failed or inconvenient J-pouch, Kock pouch or traditional ileostomy, you may benefit from a BCIR. To discuss your situation in detail, please contact Dr. Don Schiller today. Dr. Schiller will be happy to review your medical history, help you understand your options and, if necessary, perform the procedure safely and effectively.

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