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The Koch Pouch (K-pouch) is a continent ileostomy with no external pouching system that was first performed by Nils Kock, MD in 1969. Dr. Kock was a Professor of Surgery who taught and practiced at the University of Gothenburg in Sweden. He was noted for his research, experimentation, and colorectal surgical techniques that led to his breakthrough development of the Kock pouch.

Q: How does a K-pouch work?

DS: The K-pouch surgery entails the creation of an internal reservoir (pouch) from a section of the terminal ileum with a valve mechanism for no leakage of stool or gas and therefore no skin problems. A stoma is created flush to the abdominal wall and the patient catheterizes the internal pouch on an average of three times a day to drain waste matter. This differs from a traditional ileostomy surgery where part of your ileum is brought above the skin's surface to form a stoma and an ostomy pouching system is used to collect waste.

Q: What's the difference between a K-pouch and BCIR?

DS: The Barnett Continent Intestinal Reservoir (BCIR) is a modified and advanced form of the Kock pouch by Dr. William O. Barnett that creates a lateral reservoir with a single suture line. In some patients, this creates a more manageable waste removal system. The Kock pouch and BCIR vary, so knowing the differences and benefits of each procedure can help patients who are good candidates.


A Further Improvement on the Kock Pouch: A Collar on the Nipple Valve, the Barnett Modification

Q: What are the benefits of the Kock pouch?

DS: A K-pouch is both a personal and medical asset. Not only does this procedure solve many of the complications of a conventional ileostomy but it can greatly improve the quality of life for many patients.

Q: Who is a candidate for the K-pouch?

DS: Ultimately, it's up to the patient and their medical team to decide if a continent ileostomy procedure is a good choice. Both the Kock pouch and a BCIR require having an adequate length of small intestine available to create the reservoir. This procedure can be an alternative for those with a history of medical problems caused by an ileostomy or for those whose lifestyle would benefit from living appliance-free.