Reoperative Colorectal Surgery

Surgical treatment of some colorectal disorders may leave the patient with a permanent ileostomy which can adversely affect their quality of life. The surgeons at the UH Center for Reoperative Surgery have a reputation for surgical excellence and innovation in continent ileostomy procedures – a technique that allows patients the freedom of no external bag or appliance. University Hospitals is the highest volume center in the country for these procedures and our surgeons both create and repair continent ileostomies, when needed.

Our doctors are experts in both common versions of continent ileostomy surgery that can preserve continence and eliminate the need for an external pouch to collect stool. These include:

K-Pouch Surgery

Named for the doctor who developed it, Dr. Nils Kock, this procedure creates an internal reservoir (pouch) from tissue taken from the small intestine. The pouch is then connected to a small opening (stoma) in the abdominal wall by a valve (also created from a piece of the small intestine) which works to keep waste and gas inside the pouch. Several times a day, the patient simply inserts a catheter (small tube) into the valve and drains the waste into a toilet, bedpan or other container for disposal.

Barnett Continent Intestinal Reservoir (BCIR)

This is a modified version of the K-Pouch intended to reduce the risk of valve slippage, a complication that occurs in some patients. UH surgeons offer repair surgery to BCIR patients when necessary.

Ileal pouch surgery has become the gold standard for patients with ulcerative colitis who require removal of the colon and rectum due to complications of their disease. Although ileal pouch surgery is a great option to preserve a normal route of defecation for most patients, some may develop problems with their pouch that require intervention. Instead of removing the pouch and having a regular ileostomy, most of these patients can undergo a salvage procedure and continue on with their stoma-free life. The surgeons at the UH Center for Reoperative Surgery have the experience and expertise to perform this type of pouch salvage procedure with up to 80 percent of our patients experiencing a successful outcome.

An ECF is an abnormal opening between the intestinal tract or stomach and the skin – a serious complication that can occur after bowel surgery. The opening or fistula allows the contents of the stomach or the intestines to leak through to the skin, causing a wide range of medical problems that can be challenging to treat, including dehydration, sepsis, anemia and painful skin breakdown. ECFs can also cause significant emotional problems including anxiety, depression and low self-esteem.

Although some ECFs resolve with medical care including bowel rest, intravenous nutritional support, hydration, electrolyte replacement, sepsis control and wound care to protect the stoma and the skin, some ECFs require surgical repair.

The surgeons at the UH Center for Reoperative Surgery, have 30+ years of combined experience in treating this problem and work as part of a multidisciplinary team to provide patients with real hope for successful treatment of this very serious condition.

A diagnosis of colorectal cancer is always frightening. But, when it comes back after the initial treatment, it can be even more disheartening and lead patients to lose hope. Over the last several decades, the colorectal surgeons at University Hospitals have gained highly specialized training and experience in caring for patients with colorectal cancer, both after the initial diagnosis and if it recurs.

Many years ago, procedures performed to treat recurrent rectal cancer were considered strictly palliative (intended to make the patient comfortable but not cure the disease). However, we now know that with the advanced surgical and multi-modal techniques that have been developed, many patients can be successfully treated and achieve long-term survival. UH has assembled an expert multi-disciplinary team that aggressively treats patients with recurrent colorectal cancers with the goal of cure.

Because this disease typically involves several organs of the pelvis, we have a highly coordinated multidisciplinary team that includes colorectal surgeons, urologists, gynecological oncologists, radiation oncologists, radiologists, pathologists, plastic surgeons and more who meet on a weekly basis to discuss and refine each patient’s treatment plan. With over 30 years of combined experience in the management of these complex recurring cancers, our surgeons are dedicated to treating not just the physical needs of our patients, but their psychological and emotional needs as well.