Pouchomarx posted:How would they go through rectum to tack it? wouldn't that cause a leak or a fistula by puncturing the pouch to tack it?
There was a septum that developed inside the pouch. There were 2 procedures to correct it, the first in 1998 which resulted in its re-development, and the second in 2000 which was successful. I do not know exactly what Dr. Gorfine did in the second procedure ( you would have to ask him), but he told me he stapled/pinned back the septum that developed. What I can tell you for sure is that he went through the rectum with whatever he did. He did not cut through my skin. It was done as an outpatient procedure. There was no leaking, no fistula. I think I was cautioned that I could have a little blood in my stool but I was more or less good to go right after surgery.
He did many J Pouch Revisions, and my understanding was most of them were done that way- through the rectum. Back in the late 1980s, 1990s and early 2000s this surgical group probably did more J Pouch surgeries than any group in NYC, or perhaps even the USA for that matter. As I mentioned previously, the patriarch of this group who did my original surgery (Irwin Gelernt) did the very first K Pouch in the USA in 1970 and studied under Dr. Nils Kock, for whom the K Pouch is named. He later pioneered the J Pouch surgery and probably did more of them than anyone before he passed away in 1996. He was considered the best colorectal surgeon in the USA for J Pouches when I had my 2 step in 1992.