I've been reading a lot of articles lately looking at my options for the future. As of now I had a temp. ileo looking to have some type of surgery in August. Has anyone heard or know anyone with the T-pouch... all I can find is a study done with 6 people in California by one doctor. Supposedly it's a better k-pouch. Also I saw an article that people with a failed k-pouch actually converted to a BCIR, is the BCIR really that much better. Anyone know what the incidence of valve fixes are with the BCIR compared to the k-pouch. Any information is helpful thanks.

The "T" pouch was developed at USC, I believe and is a moniker of their school mascot, the Trojan. To my knowledge the surgery is only performed there. We had one member on this board who had the t-pouch and after some time it failed, she believed, (I think) it was due to her physiology. In the 8 years on this board she is the on t-poucher that has appeared. I don't know if that's because it's not performed often or if those that have had the surgery don't visit here.

Sue

Hi Mark, kpouch and bcir surgeons both say patients have a 10% chance of a valve revision at some point.

If it boils down to picking a surgeon within your traveling means who only did bcir's then that is a good choice. Along with patient referrals - so you understand the bed side manner and aftercare style to suits your needs.

Dr. Kaiser does them at USC and Suebear is correct, Sierra Barb had a T-pouch and it did fail. I saw him in Dec and he has done about 30 of them. The valve has a shape of a T and is fashioned after the urinary kock.

My understanding is that many of the continent ileostomies done today are modified BCIR pouches. We even had a surgeon at our local Fremont Kaiser that was doing them, but I don't know if he is still there. With the j-pouch, continent ileostomies are few and far between, but they sure are an attractive option for a failed pouch or for those who have issues with weak sphincters, making them poor candidates for the j-pouch.

Jan

Thanks for the responses. I definitely fall into the category of failed pouches, so that's what I'm looking at. As of now I had my loop ileostomy done by Dr. Remzi and plan to have him perform a koch pouch sometime in the fall. I just wanted to see all the options. Some of my family wants me to think about waiting, in order that maybe a better type of pouch will be made. To me I don't see much more of a option other then permanent ileostomy anytime in the near future.

Yeah, I don't see any new inventions on the near horizon...

Jan

Just a note: Dr Launer at Scripps in So Ca does not do a modified BCIR - he was trained by Dr. Kock and Dr. Gerber (my old surgeon).

The T-Pouch is a modification of the Koch Pouch that has been around for at least 10-15 years.

All modifications of the K-Pouch (T, Barnett, U, S) are associated with a 15%+ incidence of valve dysfunction that necessitates re-operation.

Best of luck Mark!

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

I have a BCIR and am extremely happy with my results. I welcome any questions. I think that all the various pouches are viable options. I think the important thing is to go to a surgeon who has performed a large number of cases.

Best of luck - Cindy Sam

I just learned yesterday that my sphincter is most likely damaged beyond repair (it was damaged during my initial surgery in Nov 07.) As you can imagine I'm pretty upset about this, but now am looking at my surgical options. I'd like to explore the option of the Kpouch over a permanent end ileo. Is Dr. Launer in San Diego the only surgeon in So CAl that is really experienced in the Kpouch. I like the idea of having a continent ostomy over the typical stoma with bag.

Hi Allison, so sorry to hear. I'm always on the lookout for more kpouch surgeons, but so far just found Dr. Launer.

But, if you want to explore a BCIR then Dr. Schiller is close by to you, too. Since you've had problems - it may be a good idea to get a consult from both surgeons and you can decide what would suit you best in the long run.