The continent ileostomy

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Abstract
In 1969 Professor Nils Kock of Göteborg published a description of a new kind of continent ileostomy. A pouch is formed of the terminal ileum. The pouch although small at first enlarges with time until its capacity is adequate to contain about one-third of the day's ileal output. The pouch is emptied several times a day by passing a catheter along a short efferent loop of ileum which is brought to the surface as an ileostomy stoma. The pouch is made in such a way that it does not develop expulsive contractions when it fills. It is therefore continent. By constructing a valve mechanism on the efferent loop continence is maintained under the stress of increased abdominal pressure as in coughing, laughing, etc. Since the pouch is continent the patient need wear no apparatus and the ileal stoma may be made flush with the skin. This paper describes the author's experience with 6 patients in whom this type of ileostomy has been constructed. The results confirm the claim by Professor Kock that the technique is of value in selected patients.