Has anyone ever gone from an end ileostomy directly to a functioning j-pouch in 2 steps (no loop ileo in between)? Any problems? I've heard some surgeons can do this.

thanks!

I am a 2-stepper. Had ileo and Jpouch all in 1st surgery, takedown is next month. Not sure what constitutes the need for 2 or 3 steps though

I think the 3 step procedure is to help people who are malnourished and weak from illness to recover and build up strength and get off drugs that will slow up healing to cope with the next stages.

There are a number of people here who did not have a diverting ileostomy after the creation of their j-pouch. This is a decision that the surgeon makes depending on your overall condition and the condition of your tissues when the j-pouch is made. For many, once the offending colon is out, the general health improves so much that a diverting ileostomy is not necessary.

Jan

thanks, I thought 2-STEP meant LOOP ILEO to J-Pouch (not End-Ileo to J-Pouch).

Love,

My surgeon almost did this with me. He felt that it would be better to try to make the loop work, for at least a short while though. This choice was made during my pouch creation surgery. I would have told him to just hook me up LOL. The loop really never worked for me, and at 4 weeks we scheduled my takedown. At 5 weeks we did the pouch check, and few days later I had takedown. All in all he still believed that it was better to give my pouch even a shortened time to heal after construction, but it made for a tough month.

2-step means exactly that, a 2-step procedure. Usually the first step is colectomy with j-pouch and loop ileostomy and the second is take-down. But, sometimes the first step is colectomy with end ileostomy only with the second step being the j-pouch creation. The second scenario is not common. Jen, in your case, it is more common to have a 3-step procedure with a loop ileostomy in the second step.

Jan

I was supposed to have a 3 step procedure, step 1 being the end ileo, then step 2 would be jpouch creation and loop ileo, then step 3 takedown. I did have then end ileo for 6 months due to need to build back up. Semi-emergency colectomy after 2 wks in hospital on TPN, IV steroids and cyclosporin failed to put me in remisson. So when I went in for step 2 to create jpouch and loop ileo the surgeon while "in there" felt that I had good rectal muscles (not sure how he could tell that!) and they checked for leaks that they would not do a loop ileo. I was in the hospital for 12 days. I've noticed on the site some who have had the 2 step with first being the jpouch creation with loop, or the 3 step and the last being just the takedown spend around 3-7 days, but I'm not sure if mine was due to the type of surgery or the fact that I always get ileus when I had anyone even look at my guts. I have no problems with my pouch. I do get pouchitis but that started about 2 yrs after my pouch surgery. I've never had pouch leaks or any issues in that way. I believe my course was about the same as everyone elses right after surgery. I have had some adhesion problems. 4 surgeries for that. But that has nothing to do with the pouch, except the fact that I had to have surgery in the first place! Hope this helps you some. Feel free to pm me if you want to know anything else.
take care
Shannon