Pouchomarx, it appears that you have made the first major decision: I do not want the bag. Here are my thoughts on your other concerns:
1.You are fortunate to have the Cleveland Clinic nearby. It is definitely a significant plus as far as follow up care, if needed ,which is best provided by the doctors that did your procedure. Plus, there is no travel involved.
2.If you have not already done so, go to the BCIR program website: www. bcir.com. There you will find a lot of information about the BCIR and their services at Palms of Pasadena Hospital. There are a number of other websites on both the BCIR and K pouch that provide additional information.
3.When you meet with your CC surgeon, you should ask him what enhancements they have made to the original K pouch procedure to reduce valve failures and fistula formation (relatively rare occurrences with both procedures) and how he compares it with the BCIR.
4.I was in the hospital in Florida for BCIR for the standard 21 days, which gave sufficient healing time for me to safely travel home to northern Wisconsin and fully care for myself. The time at CC for a K pouch would probably be quite a bit less.
5.I am retired, so return to work was not an issue. However. I had no problems going to an outdoor estate auction that lasted for 4+ hours and involved a one block walk in from where we parked. This event was one week after returning home. For your job, four weeks post-op should be sufficient, but I would consider working half days for your first week. You will have a lifting restriction prescribed by your surgeon.
6.I would think that that a leak repair or pouch redo would be best, provided your surgeon believes there will be a high chance of success.
Best of luck with whatever choice you make.
Bill

My BCIR is solid. I go to CC to see doctors there and see Dietz when I thought I had a valve issue due to c,diff. So, follow up can be done there like any other doctor. I have had nothing major happen to have to go to Florida. I did a check up 2 years out but was good to go. Consult with both and go with your gut. What I did.

Also, you think it sounds like a long time but trust me, this is a major surgery and you need that care. I did not feel ready to go at the end and it was hard. I went back to the gym 2.5 months out and worked around that time. I would say at least 6 weeks off of work.

Cleveland Clinic would be my choice, since it's right near you. They are tops in Kock Pouches there. Then you are close if anything should happen and close for appointments and scopes. Good Luck!!!!!

I am a Mayo Clinic person myself, love that place and their knowledge and expertise. That is where I go, it's closest to me, and I had my Kock Pouch done there 36 years ago. At the moment, I am dealing with valve issues. So I will be going there to see what the next step is. A scope first....then.....whatever they suggest.