Continent ileal pouch using the serous-lined principle

Objectives: The flap valve principle is not easily applicable to an ileal p ouch since a submucosal tunnel is difficult to create. We attempted to cons truct an ileal pouch with an umbilical stoma applying the serous-lined prin ciple for both ureteral implantation and construction of a continent valve. Methods: In 9 patients, a continent pouch with an umbilical stoma was creat ed entirely from an ileal segment. Adopting the serous-lined principle, a c ontinent valve was created by appendix in 2 cases, tapered ileum in 3 cases , and reconfigured ileum in 4 cases. These were implanted into the anterior suture line of the pouch and embedded into the serous-lined tunnel formed by the pouch wall. Results: Patients can catheterize the pouch easily with a 14-Fr catheter. P ostoperatively, pouch capacity is over 400 ml with complete continence. Conclusion: This technique can provide a simple and effective continent ile al pouch facilitating umbilical anastomosis. As a continent valve, the reco nfigured ileal segment seems most useful for application of the serous-line d principle. Copyright (C) 2000 S. Karger AG, Basel.