Classic Article

Diseases of the Colon & Rectum

, Volume 37, Issue 3, pp 278-287

First online:

Intra-abdominal “Reservoir” in patients with permanent ileostomy

Preliminary observations on a procedure resulting in fecal “Continence” in five ileostomy patients
  • Nils G. KockAffiliated withDepartment of Surgery 1, Sahlgrenska Sjukhuset, University of Goteborg

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Preliminary experience with a new type of ileostomy provided with an intraperitoneal reservoir is presented.

By splitting the distal part of the ileum at its antimesenteric border and folding the split intestine twice, a bladder-like container is formed by suturing the edges of the intestine. In this type of reservoir the motor activity in the different parts of the intestine counteract each other and no pressure waves appear on filling the reservoir. The outlet of the reservoir passes obliquely through the rectus muscle which closes the outlet so that no involuntary flow through the ileostomy is possible, either during rest or during coughing or straining. The capacity of the reservoir is between 300 and 600 ml, depending on the length of intestine used for the construction of the reservoir.

To date, five patients have been provided with this type of ileostomy after panproctocolectomy for ulcerative colitis, and the results obtained from these patients are very encouraging. The patients empty their reservoir one to four times every 24 hours by inserting a plastic tube through the ileostomy. There is no involuntary flow of intestinal content through the ileostomy.