Hello all,

Let me first start out by saying that I have a J-Pouch and I am VERY happy with my new quality of life. 2nd, I really don't want this to turn into a war btwn the people from BCIR that sometimes lurk and others on this board. That being said, I really want to know the difference btwn the K-Pouch and the BCIR procedure. I believe that they are fairly similar? Also, there are very few surgeons who perform the BCIR where there are quite a few skilled surgeons that perform the K-Pouch. Really just want to know the difference for my own curiosity. I don't want to hear about one being better than the other, etc. I thank you in advance.

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

They are basically the same. The major factor should be the competence of the surgeon. Both groups would like to think that theirs is better, but it is really an individual experience.
One factor that you must consider is your insurance coverage. Not all policies cover all procedures.
So long as your J-pouch works, I would not even waste my time thinking about either of these.
Good luck and stay well.
Larry

Hi Larry,

I appreciate the reply. I am not thinking about either surgery. Again, I am very happy with my J-Pouch. Just was curious about the difference as I have seen topics where the BCIR people are touting their surgery as the best and I was somewhat aware of the K-Pouch. They seemed similar, so I was just wondering what the differences are.

The main difference from a K-pouch and BCIR is that the BCIR has an internal collar [ made from the intestine ] that wraps around the base of the valve. As this 'collar' fills with gas and stool - it is supposed to provide better support for the valve and lessen the chances for valve slippage. The Kock pouch does not have this 'living' collar.

And, to add to the confusion, there are "hybrids" out there where some surgeons perform a modified Kock that is similar to the BCIR outside of specialized centers. But, overall, there are very few surgeons in the U.S. who do any sort of continent ileostomy surgery. It is a shame because it is a very viable option for those who have failed j-pouches.

Jan

Bodoni,

I am sure you know the technicals of the procedures much better than I do. I did just want to say that the fear of the valve slippage of a KPouch more than with a BCIR is the older generation of KPouches. Dr. Fazio and other surgeons at the Cleveland Clinic believe they have eliminated this problem now (though I dont know what they did to eliminate it). I wonder if one of the physicians has recently published an article on it Anyway, I do wonder if one has a higher success rate than the other. I know that when I first talked to Fazio about getting mine done, he was of the impression that it was a surgery for a niche population of us. This last visit, he seemed more of the impression that this was a good alternative for those where the Jpouch was not working or not working well.

Mike S