I'm gettin a J-pouch!!! Questions!

[Keebz]

Ok, so I had my colon removed in March of 06. (rectum was left intact - only because I was preggers at the time) but now I'm going to try the jpouch. I go see my surgeon in MN on Friday - I LOVE her, BUT...she said the surgery will probably be a 1-step procedure (as long as surgery goes well). I've been told that the 2-step is better (create pouch, then have taketown 3 months later) as it is less likely to fail. Is this true? Am I more likely to have problems if it is done in one step?? I'm completely up for the challenge of surgery and recovery - and I DO trust my surgeon 100% - just want everything to go as smoothly as possible. Any advice, or qestions of thought would be super! Thanks!

[Lynne]

I don't think I know of anyone who had a jpouch done in just one surgery. Who is your surgeon and where is she ?
You might also want to check out the discussion board at www.j-pouch.org if you haven't already.

[saxcop]

I'm suppose to have a one step proceedure in Dec. My surgeon has done about 300 of these. His partner does 2 step and has done 150.

[TheFallGuy]

Even the 2 step procedure isnt the gold standard in J pouch creation and if you really want to be safe some doctors do it in a 3 step procedure in which my was done....first they removed all of my colon and kept my rectal muscles intact....7 months later they created a J pouch for me and removed any other diseased part of my colon and 3 months after that reattached my intestines to my rectal muscles which gave me a new functioning J pouch...Most people do their J pouch surgery in a two step procedure with about a 5 month total of having to wear an ostomy appliance...was having a ostomy bag for 10 months and letting my insides a chance to heal better for me? i think so and although I hated the fact of having to wear the bag for almost a year if my J pouch was created with the ultimate time for it to heal it was all the more worth it to me...I know I say this now but so far so good...hope this helps

Jeffrey

[bbcopper]

Hola long time not talk...hehehe I just saw your post about the one or two step procedure. I am sure your surgeon is great and all, but I have to wonder what her thinking is on doing everything in one step is. Is she a certified colon rectal surgeon? how many jpouches has she done?

The reason I ask these questions is because creating the jpouch and then connecting in the same procedure is asking for failure. The reason for waiting anywhere from 3-6 (and sometimes longer) for the reversal is to give the jpouch time to heal, heal in a clean non-functioning environment (reduce opportunity for infection) and to ensure that it has been created properly (is tested for leaks before reversal is performed). Surgeons found out over the years that there was a much higher success rate when the pouch was left to heal (temp loop ileo) and then reconnected later.

I know how impatient we can be wanting to get rid of the "bag" and getting the surgeries over with, but this is something that you want to right the first time!

I would recommend to speak to some other certified colon rectal surgeons who are experienced with the jpouch to get their opinions. At the very least, if you are going to stay with your current surgeon I would tell her that you would like to do the procedure in 2 steps. Just to repeat myself...it is important to let the pouch heal and ensure that it is solid before the reversal.

The reversal itself is a less invasive procdure with a quicker recovery time.

Good luck and let me know if you have any other questions or are confused about anything I typed.

B

[HOHME]

I'm suppose to have a one step proceedure in Dec. My surgeon has done about 300 of these. His partner does 2 step and has done 150.

Hey saxcop...I'm interested...did you get the one-step procedure? If so, how did it go and who was your doctor? I'm in the current process of considering surgery and looking for some more information on the one-step. Let me know and thanks in advance for the information.