Q&A with Dr. Don J. Schiller: Is a K-pouch procedure the right option for me?

Four common questions about the K-pouch.
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Most patients who cannot have a J-pouch will have a permanent ileostomy bag. However, the Kock pouch, or K-pouch, is an alternative to a regular (end) ileostomy. The K-pouch is used in cases of ulcerative colitis when the large intestine and rectum need to be removed because of disease.

Dr. Don J. Schiller answers four common questions about the K-pouch.

Q: What is a Kock pouch?

DS: A K-pouch is a continent pouch formed by the terminal ileum after colectomy, a procedure detailed and first performed in 1969 by Dr. Nils Kock. In this operation, a valve mechanism at its exit to the skin surface leads out and is used to drain waste matter through a catheter several times a day. This is different from the traditional ileostomy surgery where part of your ileum is brought to the surface to form the stoma and an ostomy pouching system is used to collect waste.

Q: What are the benefits of the Kock pouch?

DS: A K-pouch is both a personal and medical asset. The patient does not require an ostomy pouch which can be a costly medical expense. The stoma is covered with a gauze pad, Band-Aid, or mini-pouch. The patient chooses when to empty his or her bowels.

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

DS: Because both the Kock pouch and BCIR procedures vary, knowing the differences between the two and the benefits of each can help those considering be fully knowledgeable of their ostomy options. The Barnett Continent Intestinal Reservoir (BCIR), is an advancement of the K-pouch with a modified pouch design to create a lateral reservoir with a single suture line. In some patients, this creates a more manageable waste removal system.

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

DS: Ultimately, it is up to the patient and surgeon to decide which continent ileostomy procedure is the right choice. Both the Kock pouch and a BCIR require having an adequate length of small intestine available to create the reservoir. This procedure is a good choice for those with a history of medical problems caused by an external pouch or anyone who wants to live without an ileostomy. The K-pouch and BCIR both put the patient back in control of their bowels, allowing them to live free of the burden of an external bag.

Have a question about continent ostomy surgery? Contact us and we may answer it in an upcoming article.