A poster asked me to explain the difference between a Kock and Tpouch. So I thought I would just post it for all to see. I had done it in the body of another post sometime ago.


Here is an explanation:
A T- valve is made from a 15cm segment of small intestine. 10 cm of this segment is embedded into the pouch. It is like a tube that has been sewn into the pouch. The T “pouch” is created using ileoal flaps that get folded and sewn over this access segment from two sides. The bottom of the pouch is where the embedded “tube” drains. The way the pouch is constructed and the pressure of the pouch on the valve is what keeps the pouch continent until a catheter passes through the access segment. There is no intussuscepted bowel.

The Kock valve is made by a segment of intestine that is grasped in the middle and is telescoped into itself thereby creating a double layer that is self sealing. This is an intussuscepted bowel. If it comes apart, it is a slipped valve.
The T-pouch eliminates that problem.

I hope this explains it well enough. There really isn't any info in layman's language so I did my best with some help.

This message has been edited. Last edited by: lesrich1,

Thanks Les,
Who does them???? With all of my complications and any number of slipped valves...maybe this is the right choice for me......
Maybe my surgeon could try it if he learns the technique...
Sharon

Sharon,
Dr. Greg Shore in St. Petersburg, Florida is doing them. There is another doctor, I think..don't quote me, in Michigan.

thanks Les..I hope we get some members with this new procedure sharing experiences. Always exciting to learn about options!

Here's a link from about a year ago.

kathy

Les..do you think Dr Shore's office would be willing to contact his patients with the Tpouch and see if they'd join this forum?

We only have second hand information of the tpouch failing according to the old link in this thread.

It'd be great to have a member or two share experiences! Thanks again for sharing this info!

Has anyone here had the T pouch after a failed K pouch? HOw long have you had it and how is it working???
I am in touch with my 2 surgeons and they are interested so I am willing to look into it...may be that there is another option after all...hopefully.
Sharon

There's also a surgeon at USC Norris Hospital who does them. I think he was on the team that created the procedure. My understanding is that USC developed it and named it the "T" after their mascot, the Trojan. I'm not sure of it's track record.

Sue

I checked it out on the net but have not found out any info for the conversion from k to T...doc is interested too...this next surgery is my last chance...gota get it right and if the T can give me I leg-up I will take it..
Sharon

Sharon,

The surgeon who does the T at USC is Dr. Andreas Kaiser. You can read more about him at:

http://www.uscnorriscancerhosp...octor/bio/view/72020

Sue

Thanks Sue, I have just sent a message to USC to Dr Ester Sie, hoping that she answers my request for info on the T valve...who knows...maybe this one will work...
Sharon

I will see about the patients from Dr. Shore's office coming to the forum.

My Tpouch has been functioning similarly to the Kock. The catheter goes in in a downward direction -- no turns or twists.I empty the same number of times/day. I have had some leaks. Don't know why- haven't investigated them b/c they so far been in the evening while I'm home.

I'm eating the same foods.Not sure what else I can tell you, but you may ask any ?s.

Oh Les...I forgot you have one! oh yea! will be curious to learn why leakage, but glad it's good basically!

Hi Les , I didn't know you had a T-pouch done! I haven't been keeping up on the site. Good to see you again.

You said you had some leaking, by chance do you have pouchitis? I have heard with the Kock Pouch and BCIR that you can have leakage when you have pouchitis.

So cool, you are sharing your experiences with us. I wish you the best of luck with your T-pouch . I love to hear of all the new improvements being made for continent pouches. This valve sounds very interesting. Keep us posted on how it goes!