Richard, I really admire you for explaining the thought process you went through in making your surgical choice and explaining how it worked out well for you. Many people faced with removal of their J pouches are not given the opportunity to research their options before proceeding with surgery. Unfortunately, too many doctors are not well informed about the alternatives to an ileostomy or they express negative feelings about them to their patients. Also, these options are performed by a limited number of surgeons since the J pouch has become the favored option. No one wants to be in the position of feeling, “if I had only known about available options” when the procedure they selected does not produce a satisfactory outcome.
In most cases, the bottom is sewn shut when converting from a J pouch to a BCIR. This adds little additional work for the surgeon when already removing what it is connected to (the J pouch itself). The anus is no longer needed with a BCIR or K pouch and might become the site for additional complications if it is not removed. For those opting for an ileostomy, it is possible to get a BCIR or K pouch later if the ileostomy fails to produce acceptable results. There usually is sufficient small intestine present to make the internal pouch.
Bill