Dr. Schiller & Dr. Launer: fistulas, valves & other

[MissK]

Hi,
I will be getting a continent ostomy in 2 months (yay!!!!!), but I am worried about fistulas. I've had my own problems with long-standing wounds after surgeries, so I'm hoping someone can give me some insight into fistulas. I also spoke to 2 surgeons, and they both talked down on each other's surgeries.

I spoke to Dr. Schiller (BCIR) and he said he only sees 2-3 a year, most from K-Pouches someone else did (I just find that hard to believe). He also said K-Pouches have a ton of valve problems as BCIRs don't. On the other side, he was so nice, and I loved that he asked me in detail about my history. He remembered our phone call from 4 months earlier, and really took the time to understand me.

Dr. Launer from La Jolla (K-Pouch) said that in 12 years he has never had a fistula (I also find that hard to believe). He also said that the reason BCIRs don't work is that they stick a tube into your stomach to suck out the fluids, which is unnecessary (I spoke to Schiller who said he doesn't do the tube). He uses staples to secure the valve so he said there is no need for the BCIR version. He was extremely knowledgeable and seemed like he's very experienced.

What does everyone thing about these contradicting ideas? They both don't like the other type of surgeries, but I just cant get a straight answer about some stuff.

I really want to know what the deal is with fistulas! I assumed both types of surgeries get them the same amount of time.

Also, why do they happen, and how can they be prevented? I didn't get much of an answer on that since Launer said he's never had one and Schiller said they are from patients he didn't do surgery on.

What does everyone think? I'm very critical of what surgeons tell me because of some pretty serious consequences I had after a couple of them didn't give me the 'whole story' or took liberties.


It's better to ask, ask and ask, then critique, critique, critique!!!

Thanks everyone! I'm so excited for this opportunity...since it's the most important thing I've ever done, it's better to be safe than sorry!

[Dahlia]

It has been a very long time since I have posted on this forum. That was when I had a Brooks Ileostomy. I have had a BCIR for 1 1/2 years, which was created by Dr. Schiller.

I don't know about fistullas, but I do know about Dr. Schiller. He is an incredible surgeon, man, caregiver. Tho I have had several problems that were not anticipated in the aftermath of the surgery, Dr. Schiller never wavered from his support and care. Whether I called during or after office hours, I have received immediate responses and concern from him.

I would trust Dr. Schiller like no other doctor. He really signifies the quality of health care we all need and deserve to receive.

Good luck,
Dahlia

[Shazzam]

Dr. Schiller is the nicest guy. I've only heard good things about him...but I am worried about problems afterwards that isn't really talked about beforehand. Did you have to have surgeries afterwards because of the problems? That's mostly what I'm worried about because I will be starting a career right afterwards in a new city, and I'm afraid of having to leave.

[Ronb]

MissK, I cannot reply to the fistulas because I have not experienced any since Dr. Schiller did mine over 10 years ago.

Dahlia is correct about what a great caring doctor Schiller is, and has over 17 years of experience with the BCIR proceedure. My experience has been a good one, although six months after surgery I had to have the canal where you insert the tube shortened just a little bit. I was having a little trouble inserting the intubating tube. Other than that, no bad days.

[Dahlia]

I want to respond to the concerns regarding aftermath of the BCIR surgery. For most folks, they do not have any problems. Everyone is different, of course, and all tissues respond uniquely.

My problems were not predicted: 11/07 I had to have a stoma revision b/c of some problem with the channel caused by settling of the tissue; 5/08 I had a hernia repair. Hernias can happen when the abdominal wall has been compromised as with the huge incision and stoma set-up with the BCIR.

Again, with all that having occurred, I wouldn't change it for any other substitution for my colon. I am thrilled such a procedure exists and that I live in LA near Dr. Schiller.

Best of luck,
Dahlia

[lesson]

I have a Kpouch that was done by neither doctor and I think it's great! (I've never had a fistula)

I have heard only wonderful things of both Dr. Schiller and Dr. Launer.
Both are extremely skilled in the continent procedure they perform.
Both are caring, attentive physicians.
Both will do their utmost to make sure your surgery is successful, but can not predict that you will not have 'hiccups'.
And as you have noticed. each doctor is partial to the procedure they do

Which doctor you choose is a personal preference which is not always easy to make

Keep asking questions and good luck

[Shazzam]

Who has had good results with other doctors?

[Flemmart]

I had my kpouch in 1979 by Dr. Gerber who Dr. Launer trained with. I never had any fistulas or hernias or pouchitis. I had the valve repaired in 1983 and it's been functioning terrific since.

[woodstock69]

Dr Gregg Shore does both techniques.
I believe Dr Launer does as well. It is a continent ostomy, BCIR was a franchise name tagged for the procedure.
Barnett and Koch had their own ways. Today I think the surgeons who do this really have perfected any valve issues.
Never heard of fistulas with K pouches, not like with j pouches.