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Reply to "K pouch vs. BCIR"

Just out of curiosity, does anybody know why CC Ohio has not adopted the BCIR type valve for continent ileostomy? I can't help but think there must be some downside to the living collar, since CC seems very progressive and up to date on surgical techniques. With the j-pouch, their techniques evolved with emerging trends and data. Is it just a difference of opinion regarding risk vs. benefit, or is there something else going on?

Jan Smiler

Edit: After doing a bit of looking, I found this fine article about the evolution of the continent ileostomy (2012). While it is a great article, complete with illustrations, it did not say why Cleveland Clinic has not adopted the Barnett modifications, but it does say that valve slippage seems reduced with the living collar.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400848/

This earlier article (2008) indicates that advances in the kock pouch valve reduce the need for the complex BCIR procedure. So maybe that is the reason, simplicity.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780187/
Last edited by Jan Dollar
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