My wife recently tried to change her illeostomy to the Koch Pouch. She went to Baylor Medical Center in Dallas Tx. Dr Jacobson was her surgeon. First, Dr Jacobson is no doubt a great surgeon and a great person to have at your bedside. You could set your clock to his rounds and his phone is always open for you to call. And, we could tell he has a great reputation among the entire staff at Baylor. We would recommend Dr Jacobson HIGHLY. Unfortunately, my wife fell in the catagory of valve slippage failure. The Koch Pouch lasted only a few weeks and the valve slipped. We actually believe it slipped while she was still in the hospital at Baylor because of some issues that occured with the cath. Dr Jacobson explained to me just after my wifes surgery that her case was difficult because of excessive scare tissue and he almost gave up ( something he's never done ). So, when the valve slipped, it was not a surprise and we DO NOT FAULT THE SURGEON. But, we live in Alabama ... 800 miles from Dallas when it slipped. No one in our area knew how or what to do and we drove 13 hours back to Dallas as my wife's side leaked with stool. Here's my point and why I write.....the Koch Pouch is a wonderful concept but it's not for everyone. During the 2 weeks my wife had a functional pouch, she actually had regrets for having the surgery. Yes, we surfed the forums and spoke to several people that had one, but, never actually saw it. As you all know, they're only a handful of surgeons that can perform this surgery, and Dr Jacobson is definetly one that can. But, most of you like me and my wife, have to travel many miles to meet these surgeons. Before doing so, I would encourage everyone to ask their local doctor if they are willing to learn about the Koch. Our local people could only tell us to get back to Dallas as soon as possible. With that in mind, my wife elected to go back to her illeostomy because she didn't want to have to travel 800 miles if her Koch gave her a problem. Valve slippage is usually the #1 thing that goes wrong. Another surgery may or may have not corrected the problem. If you are considering this surgery, go out and find someone with the Koch Pouch and ask them to show you in detail what is involved. We are not against the Pouch, but, we should have looked a little closer and consider after care. Dr Jacobson can be located at North Texas Colon & Rectal on Worth St in Dallas at the Baylor Medical Center. He has been there 36 years and is no doubt the finest doctor we have came across. My wife has had many surgeries and I wish we had known of him from day one.

Greg

Sorry to hear of her problems.

How many Kock pouches does your surgeon do per year? What is his success rate?

Dr. Fazio at Cleveland Clinic is about the best as is Dr. Dana Launer in CA. There are only about 3 or 4 surgeons in the country who can do these things.

J

I'm sorry that your wife experienced the slipped vavle. I hope her recovery from this surgery will be easy and she gets right back into the swing of things.

I had a slipped valve and went to a very experienced doctor not far from me. He doesn't do Kocks (I think because he doesn't want to, but he does valve repairs)He is part of the Cleveland Clinic Group. Anyway he tried three times to repair the valve but each attempt turned out not to be viable. Just one of those things.

You are absolutely right about geography playing an important part of the decision making process.

Every aspect of major surgery should be considered before embarking upon it. For me, however, 500 miles seemed and seems "doable" in order to enjoy the freedom of a k-pouch vs. the standard appliance.

And even trying situations can be funny sometimes. My local GI doctor is considered smart but without much of a sense of humor. A couple of years ago when I kept being hospitalized for acute renal failure and had a follow-up appointment in Cleveland scheduled anyway, my local GI didn't really know how to help me and strongly wanted me to travel the 500 miles to Cleveland for help. Hearing that news, my husband kind of panicked and sort of wailed to the doctor, "What should I do if she keeps getting weaker and sicker in the car on the way to Cleveland?"

My GI replied in a deadpan way "drive faster."

The good folks at CC were able to help me and I haven't had that problem since, but my husband and I still chuckle when we remember the doctor's words "drive faster."

Carol

I hope Greg is reading responses.
I wanted him to know that I did go for another Kock.
I traveled form Florida to Cleveland to have Dr. Fazio do his magic I think even if I didn't have CC in Florida to run to if necessary...I would have done it.

Dr Jacobson performs the Kock ( Koch ) Pouch procedure on a regular weekly/monthly basis. As I mentioned, the Pouch worked for a short period and my wife was one of those that was uncomfortable with the cath. We both read many stories here and are thrilled that many people can live a "bagless" life. We felt it was important to share our experience for those who are considering the same surgery. There's no doubt the Pouch is a wonderful alternative. My wife did have the option to attempt to repair the valve, but, her decision was to go back to an illeostomy. As far as Dr Jacobson's success rate, when my wife was showing symptoms of valve slippage I asked him if this is normal. He replied that it had only happen twice to him, but, was repairable. Many of the residents & senior staff at Baylor informed us many times that Dr Jacobson ( fixes ) other surgeons mistakes and sees patients from everywhere. Baylor has an entire floor designated just for his patients. I found his name somewhere on the net hidden in a forum. And yes Lesrich1, we spoke to Dr Fazio's office and considered him first but he was out of the country. Unfortunate for my wife, she needed immediate attention. And yes Lynnesa, I certainly understand "Drive Faster". HeHe. Now we can laugh. If my wife needed surgery again, Dr Jacobson would still be our first phone call. He is remarkable.

I'm glad you posted.
Another name can be added to the docs who are doing Kocks
We want to see the list grow!

Dr. Sandy Fogel in Baltimore is fantastic.

Dr Fogel is not a board certified colorectal surgeon, however, that doesn't mean he cannot do k pouch surgey in a skilled way.
I am starting to think there are many general surgeons we don't hear about who did k pouch surgery in the late 60's for 10 years or so before j pouches came about. They obviously don't get the acolades colorectal surgeons do.

My first Kock was done by a general surgeon at the Mayo Clinic in 1979. Jasmine's was done by the same doctor.

That is new to me. I am wondering how many general surgeons are capable of and actually available. Wish there was better info for this.