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What is an Ostomy?

An Ostomy is a surgical construction of an artificial opening through the abdominal wall for the elimination of waste material after digestion.

Common types of ostomy surgeries include: 

Bowel Diversions:

  • Colostomy: A portion of the large colon or rectum is removed, and the remaining colon is brought to the abdominal wall to form a stoma. It may be temporary or permanent. It requires an external pouch.

  • Ileostomy: The large intestine is removed and the small intestine (usually at the end of the ileum) is brought through the abdominal wall to form a stoma. It may be temporary or permanent. It requires an external pouch.

  • Continent Ileostomy (Kock Pouch): An internal pouch is constructed from the small intestine, with a valve, and a stoma is brought through the abdominal wall to be evacuated with a tube inserted into the pouch several times a day. This procedure has generally been replaced in popularity by the ileoanal reservoir.

  • Ileoanal Reservoir (J-Pouch): The colon and most of the rectum are surgically removed. An internal pouch is formed out of the terminal portion of the ileum that is attached to the anus, and the existing anal sphincter muscles are used for continence.  There is no stoma. In addition to the "J" pouch, there are "S" and "W" pouch geometric variants. It is also called ileoanal anastomosis, pull-thru, endorectal pullthrough, pelvic pouch and, perhaps the most impressive name, ileal pouch anal anastomosis.


Bladder Diversions:

  • Urostomy: The bladder is removed or bypassed requiring an external pouch. Either a section at the end of the small bowel (ileum) or at the beginning of the large intestine (cecum) is surgically removed and relocated as a passageway (conduit) for urine to pass from the kidneys to the outside of the body through a stoma. It may include removal of the diseased bladder. 

  • Continent Urostomy (Indiana or Kock): The bladder is removed or bypassed; an internal conduit is constructed from the small or large intestine to be evacuated through the abdominal wall.

  • Orthotopic Neobladder: A replacement bladder, made from a section of intestine, that substitutes for the bladder in its normal position and is connected to the urethra to allow voiding through the normal channel, technically not an ostomy. 

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