- Brooke Ileostomy
Also called conventional ileostomy, it was first performed by Sir Brian Brooke in England. It consists of a proctocolectomy and a permanent diversion through an end ileostomy. The terminal ileum is taken out through the abdominal wall, normally on the lower right quadrant, and the patient starts managing fecal discharges with an ostomy bag. A Brooke Ileostomy is considered the second best alternative when faced with a proctocolectomy. Continent ileostomy procedures such as the Koch Pouch and the Ileal Pouch-Anal Anastomosis (IPAA) are preferred options. A Brooke Ileostomy is geared mainly towards advanced cases of ulcerative colitis as well as colon and rectal cancer sufferers that are not eligible for an IPAA such as the elderly, those with a weakened rectum (deficient annal control), those with a cancerous rectum about to loose sphincter capacity, and those feeble patients unable to withstand a second intervention. In some cases, personal preference or fears of undergoing the complexities of two procedures make the Brooke Ileostomy the surgery of choice. Without the possibility of reversal, the Brooke Ileostomy requires permanent use of an ostomy bag and other ostomy accessories.