- Koch Pouch
Also called Continent Ileostomy, Koch Ileostomy, or K-Pouch, it was introduced in 1969 by Dr. Nils Koch from Sweden. It became the procedure of choice for total proctocolectomy up until around the 1980’s when the ileal pouch anal anastomosis (IPAA) emerged. The inability of the Koch Pouch to preserve annal continence, like the IPAA have relegated the procedure to special circumstances. The Koch Pouch consists in a surgically constructed intestinal reservoir and a non-reflux valve made from a portion of ileum. The valve, which may be seen on the abdominal surface as a horizontal 1-2 inch incision, is used as the channel to manage effluent. The patient inserts a soft catheter through the valve and evacuates about 4-5 times daily. Koch pouches were widely accepted because the valve eliminated the need to use ostomy bags. A stoma cap or patch over the incision were the only ostomy appliances required making the social impact of the procedure much less in comparison to a traditional ileostomy. The Koch pouch is contraindicated for Crohn’s disease sufferers as recurrence could contaminate the pouch. To view continent ostomy products, please click here for the Continent Ostomy Store.