In 1947, a young lieutenant-colonel was discharged from the Royal Army Medical Corps. He graduated from Cambridge University at the outbreak of World War II. After the war, he joined the newly established professorial surgical service at Queen Elizabeth Hospital in Birmingham. Years of his work focused on advancing the surgical treatment of inflammatory bowel disease. In July 1952 he publishes a paper on the care and complications of ileostomy surgery, describing a procedure that would turn the end of the small intestine (ileum) inside out and suture the mucosa to the skin — a stoma that protruded but was inverted. It was Dr. Bryan Nicholas Brooke who created this technique, known as the Brooke ileostomy.
A woman named Doreen Harris would later work with Dr. Brooke and others to start the Ileostomy and Internal Pouch Support Group (IA®), a registered charity who organized the first support groups in England. Now in its 62nd year, IA® is one of the oldest ileostomy and internal pouch support groups in the world. Doreen recalls, “I had my ileostomy in 1947 and was one of only a few people in the world who had the surgery. Very little was known about its effect on the body and no one knew how to care for it because, in those days, surgeons refused to do the operation since the ostomy appliances were useless. It would perforate and I had holes all over my abdomen through which there was a constant flow of feces.”
The description laid down by Dr. Brooke has not changed since his original paper and has provided patients with effective surgical treatment, especially for those with life-threatening diseases or injuries. As we enter the 66th year of Brooke's ileostomy, another possible paradigm is in the offering and once again it's from across the pond. In Oslo, Norway a company named OstomyCure has developed a new revolutionary solution for ileostomy patients. The TIES® System (Transcutaneous Implant Evacuation System) promises a life without skin barriers and ostomy pouches.
Rather than an end-ileostomy procedure in which the intestine is extended a few centimeters outside the abdomen, a small tube of titanium is implanted into the abdominal wall where intestine and soft tissue grow into it. The implant then becomes an extension of the intestine and protrudes only a few millimeters, where it is sealed with a lid that the patient can open to drain when needed. The lid simply functions as a stopper. The new solution (implant and lid) aims to make the patient's life easier, more comfortable, and increases quality of life. Their 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, said this in a press release. “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 select markets."
The TIES® implant received European Union’s CE Mark, meaning that it met their safety requirements for medical devices. Clinical trials began in 2009 and are scheduled to start up once again in April 2018, with further 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," Dr. Broennimann said.
OstomyCure plans to be in the United States and Canada in 24 to 36 months. Only time will tell if these trials lead to an alternative option in the surgical treatment of bowel disease.