In the late 1960’s, Dr. Nils Koch of Gotteborg, Sweden created the first Continent Ileostomy in an attempt to provide a better life style for patients whose large intestines had to be removed for treatment of colitis and other diseases.
In the past, patients requiring Proctocolectomy for ulcerative colitis needed an ileostomy to deal with intestinal waste. Patients with ileostomies needed to wear an appliance or “bag” to collect the waste. As an alternative, Dr. Koch constructed a internal reservoir by refashioning the small intestine. A one way valve, also made from the small intestine, was added to the reservoir to prevent the flow of waste to the outside until a small tube was inserted by the patient to overcome the valve.
The Koch Pouch was hailed as a major advance by patients and their physicians who realized that regaining control over intestinal function provided a much better life than the conventional ileostomy. However, the popularity of the Koch Pouch decreased when surgeons found that its construction was technically demanding and was sometimes associated with complications. The continued search for operations that preserved continence led to the development of the Restorative Proctocolectomy (J-Pouch) as the operation of choice for patients with Ulcerative Colitis.
Dr. Worsey has extensive experience with the Koch Pouch, which includes his past training at the Cleveland Clinic.
The Koch Pouch remains an excellent alternative to the Restorative Proctocolectomy in patients over age 50, in patients with incontinence, and in patients who have not had good results from prior J-Pouch operations.
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Established in 1924 by Ellen Browning Scripps, Scripps Memorial Hospital La Jolla has been one of Southern California’s premier medical centers for more than 80 years. Scripps Memorial Hospital La Jolla offers a wide range of clinical, surgical and specialty services. It is consistently recognized for quality patient care and is the first in San Diego to be designated a Magnet Hospital by the American Nursing Association for excellence in patient care.
San Diego Colon and Rectal Surgeons
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La Jolla, California 92037