Small Intestine Length

Its not the bowel length thats important its the mesentary blood supply that causes a problem. I wouldnt worry about it.

My surgeon told me "no guarantees" until he cut me open.

Also, he would not operate if you have Chrons or if you are a tall person.

I guess he wants only a high-success rate for his surgical record.

Anyway..... I am one of his success stories.

The BCIR and K Pouch procedures are commonly performed on those with ileostomies. Unless a significant portion of your small intestine was removed during your prior surgery, there should be enough left for the procedures you are considering. However, a J Pouch would not be an option if your anus has already been removed.

I had the BCIR procedure done in Florida after my J Pouch of 30 years failed. My height was not a problem (6' 4") and the surgeon used about 35 inches of small intestine to create a new pouch. I am very pleased with the procedure and my quality of life. You can get lots of information about the procedure on the BCIR (Palms of Pasadena Hospital) web site.

The typical small bowel length is about 20 feet, unless you have had some removed. Building a j-pouch uses about a foot or so at the most. So practically anybody would have enough length. It is correct that the real issue regarding length is the amount of reach of the mesenteric blood supply. Having a long trunk and a deep, arrow pelvis can add to the issue. In rare occasions it can make a j-pouch impossible. The surgeon cannot predict this before surgery is under way.

Jan

I had some small intestine removed, I originally went in for a j pouch but the surgeon said that I was about 6 inches short to form a pouch. So he gave me an end ile. I still have 1-2cm of my anal canal because he said that he left it just in case I want to try again. He said I should wait at least a year for the next try. This time I am considering going to the Cleveland Clinic in Weston. Or if they say its not a possibility then see Dr. Rehnke at the Palms in St. Petersburg. I dont think that I am close to short bowel syndrome seeing how I only empty my ileostomy pouch 3-5 times a day and that I have had blood tests done twice this year and I do not have any vitamin or iron absorbing issues. You could only imagine my disappointment when I was told that it was only 6 inches short. ugh.

I would suspect that it was 6 inches short by way of mesenteric reach, not bowel length. Hopefully, 1-2cm of rectal cuff will be enough. It definitely is not enough for a double staple technique, but perhaps for a hand sewn anastomosis. Not all surgeons are trained in that procedure, so you will need a surgeon who is experienced with that. You have the right idea of getting opinions of other surgeons. It may be a good idea to do this sooner rather than later, since you'll need to get your reports, imaging films, and labs to the new surgeon.

After waiting a few months, it is possible to use techniques for safely lengthening the mesenteric reach. This is another reason to find a surgeon with special skills. In some cases they use the s-pouch variation, which can add a bit more reach.

Good luck!

Jan

quote:

mesentary

Rhenke explained to me this is usually the issue, especially with my disease that shrinks it. I made him change the paperwork I signed. Basically said if surgery can't be done due to that (since he didn't have to remove anything to be able to tell, just cut me open), than to sew me back up with nothing removed and def no ileostomy. He argued a lot but it is my body.

Short Gut Syndrome is usually if you have had too much small bowel removed and some stomach.