A systematic description of continent ileostomy revision techniques

PURPOSE: Comprehensive description of surgical techniques for revision of complications of continent ileostomy (CI). METHODS: By analyzing 133 revision procedures performed over 30 years, a systematically classified approach to the appropriate techniques for CI revision surgery has been derived. Based on the anatomic site and severity of the respective complication, four classes of revision surgeries have been defined: class 1 refers to the nipple valve, class 2 to the pouch, class 3 to the stoma, and class 4 to the afferent loop. The severity of the complication or the complexity of the revision procedure is indicated by a subdivision from a to d. RESULTS: The surgical variants (class 1a–d, class 2a–c, class 3a–b, and class 4a–b) are shown in schematic illustrations with accompanying descriptions of technical details, the respective fields of application, and the special indications. CONCLUSION: Based on these classes of revision surgeries, the specialized surgeon may find differentiated techniques at their disposal to save the CI and avoid unnecessary sacrifice of the artificial continence organ.