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Surgical Innovation
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Holmium: Yttrium Aluminium Garnet Laser Lithotripsy for Symptomatic Kock Pouch Calculi

Mirza K. Baig, MD

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida

Brian Valerian, MD

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida

Lawrence Hakim, MD

Department of Urology, Cleveland Clinic Florida, Weston, Florida

Gamal Ghoniem, MD

Department of Urology, Cleveland Clinic Florida, Weston, Florida

Steven D. Wexner, MD

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, mcderme{at}ccf.org

Kock first described continent ileostomy for fecal diversion in 1969 as an alternative procedure to conventional ileostomy. Later, this procedure was replaced by restorative proctocolectomy with ileal pouch anal anastomosis as the procedure of choice. The main reasons for its virtual abandonment include technical difficulty, high morbidity, and the need for a stoma. To our knowledge, this report is the first published case of successful enterolith destruction and retrieval from a Kock pouch, using a Holmium: yttrium aluminium garnet laser. This outpatient procedure can avoid the morbidity and cost of a laparotomy.

Key Words: Kock pouch • enteroliths • Holmium:YAG laser

Surgical Innovation, Vol. 13, No. 3, 193-197 (2006)
DOI: 10.1177/1553350606292525
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