Continent ileostomy : a new technique in the dog

A new technique for constructing a continent ileostomy has been tested in the dog. The terminal ileum is divided 10 cm from the ileocecal valve, and the distal stump is closed. The last 35 cm of the proximal stump of ileum are used: the proximal 30 cm portion is used to prepare a reservoir ileostomy according to Kock's method, while the distal 5 cm portion is used to form the stoma. The outlet of the reservoir is sutured to the abdominal skin and is provided with a magnetic sealing device formed by a magnetic ring coated with Palacos which is implanted in the abdominal wall; the magnetic outside cover seals the stoma. Eight dogs were provided with this type of ileostomy. The observation periods did not exceed six weeks. The dogs wore the magnetic covers for 10 to 12 hours a day. Full continence was obtained in all dogs but one, in which the ring had to be explanted because of infection. Radiologic examination performed 30 days after the operation with orally administered barium demonstrated great increases in the capacities of the reservoirs and full continence of the stomas. Intrareservoir pressures recorded during infusion of fluid in the ileostomy pouches demonstrated the absence of pressure waves, even when 600 ml of fluid were introduced.