I see lots of info from or for K-pouchers but not much for the BCIR people. I'm considering BCIR, mainly cause it's in FLorida and I'm in Georgia. Does anybody have any opinions regarding K-pouch VS BCIR. I know Dr Fazio is fabulous, but going all the way to Ohio by myself is just something i don't want to do. By the way, I "had" a J-pouch, now I have a perm. Ileostomy, due to blockage. Whole story is just too long to think about right now.

Decisions decisions....Well, I didn't have the surgery, but my girlfriend did, and hence I did a ton of reasearch on both the BCIR and K-pouch, so here's what I know. Firstly, the BCIR, as I'm sure you know, is just a modified k-pouch. They send you a nice brochure and dvd documenting all the wonderful innovations of this 'new' procedure. Well, here's some problems I found. The doctor who came up with the BCIR passed away a little while ago, though he had taught some of his students how to perform it. But if the BCIR was so awesome, don't you think it'd be performed at more than one or two hospitals, and by more then just one or two doctors? That leads to another problem. Yeah, Florida is closer, but the place where they perform the BCIR is a private hospital, and trust me, tack the word private onto anything and you'll be paying at least double what you ought to be (i'm at a private university, and i'm a little bitter hehehe). Plus, you'd be solely dependent on that hospital for everything you needed.....they'd own you....Okay, nuff bout the BCIR. The K-pouch isn't a heavensent either though (i hope there are no k-pouches in heaven!), but I think its the better option. First off, some of the best hospitals in the U.S. (cleveland clinic and mayo clinic) perform this operation, and there are dozens of institutions learned enough to take care of it. And then theres Fazio. Basically take every good thing you've heard about him and multiply it by 5; the man knows his ****, pun intended. He too made some modifications to the k-pouch, strengthening the valve, and increasing the success rate and longevity of it all. Again, I didn't have the surgery, but I have the most beautiful woman in the world by my side as proof that it works, and works well (and yeah, Fazio hooked her up). Its true, Ohio is much farther from Georgia than Florida, but think about it, nobody is flying to Ohio, especially not Cleveland, unless they really need something (aka tickets are cheap, and plentiful). In my opinion, i'd strongly consider the k-pouch: its done more which means more is known about it, its more than likely gonna cost you less, and I know it works, I've seen it work (its kind've fascinating really). Well, theres my opinion for ya, hope it helps!

My BCIR was created at Palms of Pasadena Hospital in St. Petersburg, Florida. I have had absolutely NO problems with the exception of an occassional bout of pouchitis. (I converted from a j-pouch). Palms of Pasadena Hospital is a private for profit hospital and they are extremely dedicated to the procedure. After 15 plus years, I can call that team of health care providers and receive a return call sooner then I would from my local doctor. I have absolutely no regrets that I opted for the Barnett procedure. The BCIR is a modification of the K pouch. The K pouch done now a days is a modification of the K pouch done in the 80's and in fact probably has the Barnett modifications without giving him credit. I would say that you are in good hands with procedures at the facilities mentioned in these few posts. If you want to know more about my experiece, feel free to email me at momboys@hotmail.com.

Dana Launer in San Diego, Joel Bauer in NYC and Vic Fazio at the Cleveland Clinic all do the old-fashioned Kock pouch at the old-fashioned prices. ;-) And they don't rip off anyone or steal any techniques without giving credit.

Basically they are both just variations on a theme. They are both continent ileostomies using internal ileal pouches. Nothing specifically magical about either one. All forms of surgery are constantly being updated and improved, including the j-pouch.

The main thing is to find a surgeon who performs the procedure you want at a facility you are comfortable with. Insurance coverage is also an important consideration. I know that they were doing a modified BCIR at our local Kaiser Hospital a few years ago, but I don't know if they still do. It really does not matter what you call it as long as you understand what it is.

Jan

The old fashioned Kock Pouch has been modified, it isn't the same operation it started out to be. The "modified" Kock Pouch of today is updated just like all surgeries are. I totally agree with Jan, they are both continent ileostomies. Prices are different, length of stay in the hospital is different and the Kock Pouch is done in more places. There are also more up to date studies on the Kock Pouch out there. I would like to see updated studies on the BCIR and more places doing it. I never want to see the day this alternative fades out whether it be the Kock Pouch or BCIR. I feel it gives people choice, a choice that is important.

I wish the Kock Pouch and BCIR were done all over the world. I think the continent ileostomy is a wonderful alternative or should even be first choice for surgery. Insurance coverage has alot to do with what operation they will cover, what they will pay for an operation, how long of a stay they will pay for and what hospitals they will pay too. In my opinion, insurance companies have gotten way out of hand on medical care decisions that should be the doctors and patients decision.

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

Just for a point of information the main Dr. who did the BCIR surgeries at Palms of Pasadena Hospital in St. Petersburg, Florida passed away unexpectedly in August of 2005.

I know because he passed away the week of my surgery.

I'll throw this in....Dr. Pollack passed away the week he was to do surgery with one of the doctors at Clevland Clinic Weston.

Sara Jean....did you have surgery by one of the other doctors?

The BCIR and the Fazio version of the K-pouch were both developed to decrease the frequency of valve slippage, the most common complication of the original Kock pouch.
The BCIR uses small bowel wrapped around the valve as a 'living collar' to prevent slippage. Dr. Fazio actually staples the valve to the pouch wall. Both methods have improved the problem of valve slippage. Fazio's method is probably easier and quicker, resulting in less time in surgery.
The BCIR center will gladly give you a list of patients willing to share their experiences. I would take advantage of that.

lesrich1

Yes, actually. I had set it up to have Dr. Wexner of Cleveland Clinic to attempt a Jpouch. My Jpouch failed 3 years before. I was only 17 and my mesentary didn't stretch. I didn't want to wait between surgeries to get a BCIR pouch, but both doctors wanted me to try a Jpouch first.

Dr. Pollack was to assist Dr. Wexner with the Jpouch surgery, and if the Jpouch failed and I needed a BCIR, Dr. Wexner was going to assist Dr. Pollack. From my understanding they both were equally excited in working together.

I believe he passed away on a Monday, my surgery was that Friday. I had many angels that day because my jpouch worked.

quote:

I believe he passed away on a Monday, my surgery was that Friday. I had many angels that day because my jpouch worked.

Wow that is amazing SaraJean! God works in mysterious ways. Sometimes we don't understand.
An aquaintance of mine was one of Dr. Pollack's very last surgeries. She was very upset because he passed only a couple of days after she had been in recovery.

Dr. Pollack was my surgeon and one of a kind at that. I have since met Dr. Rehnke at a seminar who is the other surgeon at Palms of Pasadena Hospital. He has assisted on 100's with Dr. Pollack and has performed over 500 BCIR patients himself.