who here has had this procedure in a 1 step and what was your outcome? i have mild UC and not many flares. i am on asacol daily and i have only been on 30mg prednisone 2 times and that was within the year. i need surgery due to low grade dysplasia throughout my entire colon. i am otherwise pretty healthy and i am in remission right now. what are odds i can get the 1 step done? and what are the risks? is it safer to have the 2 step done anyway? i am going to the cleveland clinic so what doctors there would consider 1 step? i also am hoping for laroparascopy. i am 5'8 and weight 150lbs.

I had a one step laproscopic procedure done and I highly recommend it. My surgeon does most of his procedures this way, he feels there are less complications. You will find alot of different opinions on this. The most important thing is to find a surgeon that is qualified and has done many of these procedures successfully. Also, the surgeon won't know until he goes inside if it's possible to do a one step. There is certain criteria that needs to be met. You need to be mentally ready for an ostomy, in the event a one step isn't possible.

I'm not sure which doctors in Cleveland do one step procedures. I had my surgery done by Dr. Jeffrey Milsom in NYC.

Good Luck to you, and if I can answer any questions for you, please let me know.

janna

thegoose, sorry I missed your post. I am sort of a one stepper. I had the pouch created and take down in one shot. I am copying my post to another wowen who was considering. Good luck.

I had your situation. In June '06 I had my colon removed and ileostomy create but the doctor left in the rectum and anus. The reason was they didn't know if I had UC or Crohn's and they wanted to do pathology on the colon and give me the option of going for the J Pouch. Doctors decided my case leaned heavily toward UC and offered J pouch. Thing was, I was so relieved to not be sick anymore that I actually waited until January 8, 2008 to go for the J pouch. I was also afraid of many things, mostly failure of the pouch and more surgeries. I decided to go forward. I was able to get it done in one step as opposed to two. Surgeon told me he could not make decision until he was inside but if things went well and I authorized he could do it in one surgery. He had done 50 J pouch surgeries in one step and said that 3 failed and required emergency surgery from leakage. I went for that result and had it in one procedure waking up from surgery to feel for my stoma and it wasn't there. Only time will tell if I made the right move, and I'll admit I had some buyer's remorse over this past month. The recovery has been slow and complicated. I think one step makes it harder to recover, and was riskier, but I also think the fewer surgeries the better and go for the best result.

i was told all surgeons at the cleveland clinic only do 2 step procedures. which is what i'll get. bag only for 3 months.

I had a 1-step in 1995. I had complications, but I was not as good a candidate as you. I was on high dose steroids and in a very active flare at the time. Still, I am fine now and have no regrets. I think it is important to let your surgeon decide what is the best type of surgery for you. Plus, they don't know for sure what they can do until they get in there and see.

If you do a search, you will find quite a few threads on this topic.

Jan

I knew someone who it was an issue with. She got an infection, leaking, etc. I know the bag is hard, but it can save issues later on.

I had a one-step in 1996 and I am still doing great. I had an (amazingly)non-complicated recovery. Of course, 11 years later I developed an RV fistula, but i've had 10 PERFECT years before that.

1-step, or 2-step, or even 3, Good luck to you!

Corie-jay

i just had 1 step done in Nov 2007. I am very happy with it. I had a hard time the first month, I didnt have an appetite at all, and lost wieght was very weak. once i started eating I did great. I had UC for about 17 years. the past 5 years were a nightmare, constant flare, hospitalized a lot constantly needing transfusions.... I am kicking myself for not doing this sooner! i have a very small scar ( i wore a bikini a few weeks ago!) I was afraid of cancer since having UC for so long, so I had everything removed. I poop lots, its getting less & was told it could take up to a year to find a "normal" state. Very happy !!!!

I got my 1 step on August 2007, and except for a few incidents of "clogs" in the beginning and an intestinal infection, I can not be happier! I got my life back! It is a huge weight off my shoulders, and people keep telling me the see a huge improvement all around. I had it done laprascopically, and I think I was in the hospital for 10 or 11 days. Recovery was pretty quick! By Christmas it was like I had never even had the surgery! One word to describe the entire thing: Awesome! All in thanks to Dr Shore at The Center for Intestinal Continence at St Anthony's in St Petersburg, FL You can read and see pics from right after my surgery on my blog. Good luck!

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

Katrin
What wonderful news.
I am sure your daughter is happy to have a healthy Mom and your husband has a healthy wife!

I had a one step j-pouch procedure June/07)because of low grade dysplasia that had changed to high grade. My surgeon would not perform it laproscopically as when there is any chance of cancer they want to make sure to 'get everything' which is apparently easier in a traditional surgical procedure. I was in the hospital for ten days as I had severe nausea which prevented me from being able to eat. Once that passed I improved rapidly and was able to be quite mobile despite the large incision. I have no regrets re the one step.
Good luck!
Rhema

One step in January 2007. I'm not saying that it's the reason I have had so many problems, but if I had to do it again, I'd do 2 step.

I had a lot of pain, which later was found out to be a fistula. In October I had a failed fistula repair, followed by a temp ileo. Had a repair in Feb, not sure how it's turning out. I have been having pain the last few days and I am a month out.

My daughter had the 1-step surgery in June 2005. She was an excellent candidate, but two days after, her pouch ruptured and she ended up in emergenecy surgery, creating the ostomy and living in Pedi ICU for 3 days. Even with excellent candidates there is a chance of a rupture. Have the 2-step surgeries, and don't chance it. Our surgeon was extremely confident and I don't blame him at all, it was just not to be. My daughter is now a healthy, growing teenager, takes no meds, has 5-7 movements a day, and is the best UC success story. Best of luck I know how hard this decision is. Prayers to you.

Just so you all know, leaks and pouch ruptures can occur regardless, particularly if you have the colectomy and pouch formation in the same surgery (with or without a diverting ileostomy). If you have a 3-step, which is not often done, these risks would be reduced.

Jan