Kock Pouch Construction: Our Approach

Abstract

Over the course of greater than 40 years we have revised the approach to Kock pouch construction from the original description by Professor Kock in 1969 in an attempt to improve pouch function and reduce the risk of complications and revisions. Over this period, 194 patients have undergone Kock pouch construction and/or revision at our institution, with an estimated 20-year pouch survival of 67%. The most common complication remains valve slippage which may be corrected in approximately half of the patients undergoing revision. Overall, our patients undergoing Kock pouch surgery report an excellent quality of life. We present here a review of the evolution of primary Kock pouch construction at our institution, and a detailed illustrated description of our current operative approach and post-operative care for the Kock pouch.