In 1947, a young lieutenant-colonel was discharged from the Royal Army Medical Corps to become a lecturer in Surgery at The University of Birmingham and worked at Queen Elizabeth Hospital England—he would spend the next 16 years there. In July, 1952 he published a paper about the care and complications of ileostomies. As part of the text, he described a procedure that would turn the end of the ileum inside out and suture the mucosa to the skin. It was Dr. Bryan Brooke who created that technique—a stoma that protruded but was inverted.
As Doreen Harris recalls, “I had my ileostomy in 1947 and was one of only four or five people in the world who had the surgery. Very little was known about the effect of it on the body and certainly no one knew how to deal with it. In those days, surgeons refused to operate because appliances were useless. We were allowed to perforate and I had holes all over my abdomen through which there was a constant flow of feces.” Doreen would work with Dr. Brooke and others in founding IA®, the Ileostomy and Internal Pouch Support Group, and organizing the first support groups in England. The IA®, now in its 62nd year, is one of the oldest ileostomy and internal pouch support groups in the world.
As we enter the 66th year of the Brooke Procedure, another possible paradigm in surgical treatment is in the offering, and once again it is coming from across the pond. In Oslo, Norway a company called OstomyCure AS, has developed a revolutionary solution for ileostomy patients. The Transcutaneous Implant Evacuation System, TIES® System, promises a life without skin barriers and pouches.
Instead of conventional stoma surgery in which the intestine is extended a few centimeters outside the abdomen wall, a small tube of titanium is implanted into the abdomen where the intestine and soft tissue grow into it. The implant then becomes an extension of the intestine and sticks out a few millimeters on the outside of the abdomen where it is sealed with a lid that the patient can open to drain whenever necessary. The lid quite simply functions as a stopper. The new solution (implant and lid) aims to make life easier, more comfortable and increase the quality of life for many patients. OstomyCure AS site states, "the TIES® implant is designed for life-long use and will dramatically reduce skin problems as the device only needs to be cleaned with tap water and no disinfectants or glue will be used."
Dr. Ben Broennimann, CEO of OstomyCure AS, says: “The new implant integrates well in the body. There were no infections or rejections. The first patient went well and the implant is working great with the lid. The patients went back to work, to do sport and even going to the swimming pool. The implant has been CE marked in June 2016 and will be distributed in selected markets."
The direction of the TIES® System is to provide an ileostomate with a non-adhesive appliance that decreases the occurrence of skin and leakage problems. TIES® implant has received the European Union’s CE Mark, meaning it has met their safety requirements for medical devices. Clinical trials began in 2009 and are scheduled to begin again in April, 2018 with follow-up through 2019. These trials will take place in Sweden and England. "We know that TIES Solution is a safe concept for ileostomy patients What we would like to establish is a scientifical base which will prove our product claims in a small number of clinical centers" says Dr. Broenniman. OstomyCure AS plans to be in the United States and Canada in 24 to 36 months. Only time will tell if these trials lead to the next paradigm in the treatment of bowel diseases.