An ileostomy is done in a hospital under general anesthesia.
After you’re unconscious, your surgeon will either make a cut down your midline or perform a laparoscopic procedure using smaller cuts and lighted instruments. You will know prior to the surgery which method is recommended for your condition. Depending on your condition, your surgeon may need to remove your rectum and colon.
There are several different types of permanent ileostomies.
For a standard ileostomy, the surgeon makes a small incision that will be the site of your ileostomy. They’ll pull a loop of your ileum through the incision. This part of your intestine is turned inside out, exposing the inner surface. It’s soft and pink, like the inside of a cheek. The part that sticks out is called a stoma. It may protrude up to 2 inches.
People with this type of ileostomy, also called a Brooke ileostomy, won’t have control of when their fecal waste flows into the external plastic pouch.
Another type of ileostomy is the continent, or Kock, ileostomy. Your surgeon uses part of your small intestine to form an internal pouch with an external stoma that serves as a valve. These are stitched to your abdominal wall. A few times per day you insert a flexible tube through the stoma and into the pouch. You expel your waste through this tube.
The advantages of the Kock ileostomy are that there’s no external pouch and you can control when you empty your waste. This procedure is known as a K-pouch procedure. It’s often the preferred method of ileostomy because it eliminates the need for an external pouch.
A different procedure, known as the J-pouch procedure, may be performed if you’ve had your entire colon and rectum removed. In this procedure, the doctor creates an internal pouch from the ileum that is then connected to the anal canal, allowing you to expel your waste through the usual route with no need for a stoma.
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