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The continent reservoir ileostomy procedure appears to be coming into its own for selective use in experienced hands. According to the Swedish surgeon who pioneered this technically difficult approach, operative mortality and complications have declined considerably.
The technique involves shaping an internal pouch, with a valve, from a patient's healthy bowel tissue after surgical removal of diseased intestine (and perhaps other organs). A stoma is made just above the pubic hairline, and the patient drains the internal pouch three or four times daily by inserting a tube from the stoma through the valve and flushing fecal matter out with water.
For well-motivated patients, this rinsing procedure is not overly difficult and takes five to ten minutes. Patients have virtually no dietary restrictions.
Between intubations, a compress is taped over the stoma, and the patient need not wear an external pouch over the opening. With regular drainage, the patient
Results of continent reservoir ileostomy procedure improving. JAMA. 1980;244(16):1763–1764. doi:10.1001/jama.1980.03310160003001
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