Ileostomy

A surgically created opening in the small intestine, usually at the end of the ileum. The intestine is brought through the abdominal wall to form a stoma. Ileostomies may be temporary or permanent, and may involve removal of all or part of the entire colon.

Ileoanal Anastomosis

This is now the most common alternative to the conventional ileostomy. Technically, it is not an ostomy since there is no stoma. In this procedure, the colon and most of the rectum are surgically removed and an internal pouch is formed out of the terminal portion of the ileum. An opening at the bottom of this pouch is attached to the anus such that the existing anal sphincter muscles can be used for continence. This procedure should only be performed on patients with ulcerative colitis or familial polyposis, and who have not previously lost their rectum or anus. It is also called J-pouch, pull-thru, endorectal pullthrough, pelvic pouch, or a combination of these terms.

Continent Ileostomy

This surgical variation of the ileostomy is also called a Kock pouch. A reservoir pouch is created inside the abdomen with a portion of the terminal ileum. A valve is constructed in the pouch and a stoma is brought through the abdominal wall. A catheter or tube is inserted into the pouch several times a day to drain feces from the reservoir. This procedure has generally been replaced in popularity by the ileoanal pouch. A modified version of this procedure called the Barnett Continent Ileal Reservoir is performed at a limited number of facilities.