IPAA and continent ileostomy - Kock pouch and modifications

The Pouch workshop is a training initiative by ESCP's European School of Coloproctology to promote theoretical background knowledge and practical experience on the ileoanal pouch procedure and two different variants of a continent ileostomy. 

We cordially invite experienced coloproctologists with a special interest in IBD and hereditary disposition to GI cancer to attend. Clearly, whilst an ideal ileoanal pouch may last for a lifetime, unfortunately in a substantial number of patients pouch failure is an issue. We will discuss controversial aspects of fashioning an ileoanal pouch and this year are very happy to extend our faculty and add the approach of robotic pouch surgery. Also, in last year’ s course we discussed and practiced 2 different types of continent ileostomies and this year will additionally present the less-known T-pouch and discuss the Barnett pouch. Since continent ileostomies offer excellent function and are experiencing a deserved revival we look forward to hosting a second workshop on the topic this year, after a very successful initiation of the workshop in 2018.

Management of these very special patients can only be successful if we cooperate closely with stomatherapists and nurses and we will continue to endorse and pursue structured patient care across Europe, together with the relevant associations representing these. We encourage building a tandem structure, so that combined applications of surgeons together with stoma therapists are strongly encouraged.

Therefore we invite stomatherapists, nurses and other interested parties to join the first (theoretical) day of the workshop at a very reduced rate, we would love to see you there!

On the first day of the workshop, we will address the relevant aspects of ileoanal and continent pouches, including evolution, indications for conversion, practical aspects of how they are fashioned and management.

On the second day participants will split up and surgeons will have the opportunity to in the porcine animal model fashion a laparoscopic ileoanal pouch and then transform this to a continent ileostomy under preservation of the reservoir to multiple versions of a continent ileostomy (K-S- B and T-pouch). Stomatherapists and nurses will discuss handling and management of patients with continent ileostomies and discuss challenges but also the building of a European (virtual) service to assist patients requiring emergency support. During this time, there will be a live transmission from the OR and the opportunity to observe the pouch fashioning with interactive opportunities.

ESCP logoEHTG logo


Johnson Johnson Institute entrance

This workshop has been made possible due to the generous support of Johnson & Johnson.

Johnson Johnson Institute

We would like to acknowledge Frankenman for the support of a required, specific medical device.

Frankenman


Introduction

Selection - Course

This highly interactive expert 2-day workshop is designed to teach and discuss both the ileoanal pouch (IPAA) and continent ileostomy.

StageDescription
Selection

Surgeons interested to participate in the programme will be selected according to selection criteria (see below). 

Additionally we most cordially welcome stomatherapists interested in ileostomas, virtual (ghost) ileostomies and continent ileostomies to join the first theoretical day on Thursday at a very reduced price.

Course Successful candidates will be invited to a 2-day hands-on course at the European Surgical Institute in Hamburg, Germany.

Selection criteria

  • Appropriate experience but not mandatory to have experience with ileoanal pouches.
    • Describe your level of experience with ileoanal pouch surgery (how many procedures performed)
    • Describe if you have any experience with continent ileostomies

Course

  • Two-day course in Hamburg
  • Hands-on operative training on animal models

Course structure

Venue: Johnson & Johnson Institute, Hummelsbütteler Steindamm 71, 22851 Norderstedt, Germany

Day 1 (to be confirmed) 

TimeSession
09:00 - 09:15 Registration and Welcome Coffee
09:15 - 09:20 Welcome - Gabriela Möslein
09:20 - 11:15

Session I - Ileoanal Pouch (with videos)

  • Evolution and History - Karl-Wilhelm Ecker
  • How I do it (shape and size of reservoir) pro K-pouch - Tom Øresland
  • How I do it (shape and size of reservoir) pro J-pouch - Zane Cohen
  • How I do it (optimal lengthening of mesentery - ICG) - Mattias Block
  • How I do it (taTME and virtual Ileostomy) - Gabriela Möslein
  • Robotic vs Lap Proctocolectomy - Andreas Kaiser
11:15 - 11:30 Coffee Break
11:30 - 13:10

Session II - Continent Ileostomies (with videos)

  • The continent ileostomy (K-pouch) - Mattias Block
  • The continent ileostomy (S-pouch) - Karl-Wilhelm Ecker
  • The continent ileostomy (B-pouch) - Tom Øresland
  • The continent ileostomy (T-pouch) - Andreas Kaiser
  • The Canadian Experience - Zane Cohen
13:10 - 14:00 Lunch
14:00 - 16:00

Session III - Special indications and failures

  • Conversion of ileoanal pouch to continent ileostomy - (S (Ecker), K (Block), (T (Kaiser), (B (Øresland) 5 minutes each + 10 minutes discussion
  • Pouches, FAP and desmoids - Gabriela Möslein
  • Slippage, short valves in K- and S-pouches - Karl-Wilhelm Ecker
  • Slippage, short valves in BCIR pouches - Tom Øresland
  • Slippage, short valves in T-pouches - Andreas Kaiser
  • Esepsis, fistula, pouchitis, sticture, pre pouch problems, second pouches - Zane Cohen
  • Discussion
16:00 - 16:15 Coffee Break
16:15 - 17:45

Session IV - Postoperative care, Patients and Stomatherapists perspective

  • Postoperative management from day 1-14 and beyond - Eva Carlsson
  • Real life with a continent ileostomy: 30+ years of personal experience - Q&A - Julie Klippgen
  • How can we deal locally with acute/emergency problems?
  • Situation in Göteburg - Eva Carlsson
  • Sitation in Edinburgh - Alison Crawshaw
  • Role of stoma therapy for Kock pouches in Germany/Europe: when, how, where - TBC
  • Initiatives for a European network for continent ileostomy patients - Werner Droste
17:45 Adjourn to hotel
19:30 Course dinner - Venue TBD

Day 2 (to be confirmed)

Hands-on Training Course for Surgeons in the OR

TimeSession
09:00 - 09:05 Welcome
09:05 - 09:20 KP-Survey results from EOA (European Ostomy Association) reflecting status quo and motivation - Maria Hass
09:20 - 10:00 General Discussion and Reflection on Day 1
10:00 - 10:30

Introduction: Animal Lab including anatomy

10:30 - 13:00

Surgeries with Faculty

Procedures (simultaneous teaching with videos)

  • Laparoscopic ileoanal pouch
  • Conversion ileoanal pouch to K-Kock-pouch
  • Conversion S-Kock-pouch to secondary ileoanal pouch
13:00 - 13:30 Lunch 
13:30 - 15:30
  • Conversion ileoanal J-pouch to S-Kock-Pouch
  • Valve renewal
  • Construction of a T-Pouch
  • Construction of a B-Pouch
  • Interposition of a jejunal pouch
15:30 - 16:00 Final questions and answers
16:00 Course Ends

In Parallel:

Stomatherapists and Nurses with Live Transmission from the OR

TimeSession
09:00 - 09:05 Welcome
09:05 - 09:20 KP-Survey results from EOA (European Ostomy Association) reflecting status quo and motivation - Maria Hass
09:20 - 10:00 General Discussion and Reflection on Day 1
10:00 - 11:15

Session I - Pre-Post and discharge planning and follow up of patients with a continent ileostomy

  • Overview of the programme
  • Pre-Operative conseling including stomasiting - Eva Carlsson, Alison Crawshaw
  • Post-Operative care of the continent ileostomy, quality assurance, discussion from day 1, bandaging techniques, practical examples - Eva Carlsson, Alison Crawshaw
  • Discharge planning and education of Continent Ileostomy - Eva Carlsson, Alison Crawshaw
11:15 - 11:30 Coffee Break
11:30 - 12:30

Session II - Live Surgery with Faculty 

  • Conversion Ileoanal pouch to K-Kock-Pouch
12:30 - 13:00 Lunch
13:00 - 14:00
  • Conversion S-Kock-Pouch to secondary ileoanal pouch
14:00 - 15:30

Session II - Complications - Action and Treatment

  • High-Output with a continent ileostomy, what to do and why - Eva Carlsson 
  • Leakage and peristomal skin problems with a continent ileostomy - What do we do and what appliances can we use? - Eva Carlsson, Alison Crawshaw
  • Intubation difficulties with a continent ileostomy (slippage of the nipple valve, stenosis, nipple prolapse) - Eva Carlsson, Alison Crawshaw
  • What do do as stoma care nurses
  • Other complications?
  • How do we work together in Europe with a network for patients with a continent ileostomy - discussion - Werner Droste and all participants
15:30 - 16:00 Final questions and answers
16:00 Course Ends

Faculty

  • Gabriela Möslein (Germany)
  • Tom Øresland (Norway)
  • Karl-Wilhelm Ecker (Germany)
  • Mattias Block (Sweden)
  • Zane Cohen (Canada)
  • Andreas Kaiser (USA)
  • Eva Carlsson (Sweden)
  • Werner Droste (Germany)
  • Alison Crawshaw (UK)
  • Julie Klippgen (Germany)
  • Maria Hass

Costs

The workshop costs are:

  • 14 November - Theory: €300.00
  • 14 November - Theory: €100.00 (Stomatherapists, nurses)
  • 14 November - Theory: €175.00 (Y-ESCP members)
  • 15 November - Hands-on (porcine model): €750.00
  • 15 November - Hands-on (porcine model): €375.00 (Y-ESCP members)
  • 15 November - Practical training (Stomatherapists, nurses)
  • Full 2-day workshop: €1000.00
  • Full 2-day workshop: €500.00 (Y-ESCP members)
  • Full 2-day workshop: €250.00 (Stomatherapists, nurses)
  • Course dinner at TBC (14 November): €75.00

Costs exclude travel and accommodation for the two-day course in Hamburg


Application process

Applications WILL OPEN SHORTLY

Selection will be by online application - click here to submit your application.

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