I was surprised that the first colorectal surgeon I visited does not do this procedure. In your experience, do most perform this operation? If not, why?

UPDATE: Ok, now I'm getting really frustrated! No surgeons in the area seem to do the K Pouch procedure. I was told today that there is too much risk of fistulas forming at the site of the pouch to the skin - and yet I haven't read anything about this on the forum yet where K Pouches are concerned. My next stop will be Dr. Rolando Rolandelli in NJ. I hope he can help....

This message has been edited. Last edited by: DeathStalker,

The K-pouch is a difficult surgery and today most folks are going for the J-pouch.

Dr. Joel Bauer in NYC can make a good K-pouch.

Dr. Renke in St. Petersburg does the K-pouch which is called the BCIR. The collar and valve make it a bit different the standark K-pouch.

A Dr. Shore in Sarasota does the K-pouch.

I have had a Kock pouch since 1976 done by Dr.
Bauer in NYC. I would not let anyone outside NYC or Florida do a Kock pouch.

I second Bodoni's advice. I've had The Florida bcir for eight years with little or no trouble.

Ray

I think two surgeons at the Cleveland Clinic do K-pouches: Dr. Remzi and Dr. Dietz. Both were trained by the renowned surgeon, Dr. Vincent Fazio, who may be still at the Clinic, but in an administrative capacity.

Dr. Fazio made my K-pouch and I couldn't be happier.

Since US News and World Report ranks the Cleveland Clinic #2 in gastroenterology in the whole country, and the #1 site, the Mayo Clinic, does not perform K-pouches, I would always feel safest at the Cleveland Clinic.

I visited a couple of the other places where K-pouches are performed, and though the surgeons may be great, the hospitals that I visited were not 4 star establishments.

quote:

A Dr. Shore in Sarasota does the K-pouch.

Dr. Gregg Shore in St. Petersburg does Kocks and Jpouches and the Tpouches.

He did a colorectal fellowship at the Cleveland Clinic where he trained with Dr. Fazio.

I have an appointment on Tuesday with Dr. Ronaldo Rolandelli out of Morristown, NJ, who specializes in the Koch Pouch. If anyone has info on him, I'd greatly appreciate it.

Why do you want to have the k-pouch instead of the j-pouch? It seems that if you do actually have Crohn's disease that you'd opt for an ostomy rather than either a j- or a k-pouch.

kathy

quote:

o have the k-pouch instead of the j-pouch? It seems that if you do actually have Crohn's disease that you'd opt for an ostomy rather than either a j- or a k-pouch.

I can't do the J Pouch. The two setons I have down there would complicate matters too much. The anastomosis could run into issues. On the other hand, the K Pouch is no where near the setons in my anus.

Some members here have crohns and/or fistulas (with UC, not crohns) and the kpouch/bcir.

The continent ostomy is a reservoir that is emptied through a small flat stoma via a catheter. Right, deathstalker, no where near your anus.

Great luck in your appt. ask questions and try to get a patient referal from your surgeon. It's good to know his and his team's process for this surgery, and to have a buddy possibly nearby!

Thank you Janice. This is what I was trying to get across to some of the other posters. The K Pouch stoma is near the naval from what I can tell, nowhere near the anus, where my two seton drains are.

You might also want to ask your surgeons whether or not going with an ileostomy for a period of time would also aid in healing your fistulas. If the fistulas can be healed this might give you more options.

kathy

Well, one of the fistulas still drains via the seton. The other, not so much. My doctor said I'm in the 1% of patients who's fistulas never close up. He's not sure why.

This is going to be tricky, because when I get either the K Pouch or the End Ileostomy, I am assuming they're going to have to remove my colon, rectum, AND anus. If they remove the anus or sew it up, what becomes of the two setons there? Any surgeon who does these procedures is going to have to address this issue.

I guess they could leave the anus intact and just remove the rectum. This would leave the two setons in there to drain forever. This may be the better option? Who knows? Hopefully, they will...

Your surgeon will really be best to discuss the possible long term seton draining issues.

Since these threads get side tracked from the original topic, you may want to start a new one in the kkorner to see if anyone is dealing with it.