The topic at hand is about a new ostomy solution called the "TIES Solution" (Transcutaneous Implant Evacuation System) developed by OstomyCure. This innovative approach involves a titanium implant at the stoma site, which is covered by a cap with a hinged trap-door. Waste is drained by opening this door, and a bag holder can be clipped on without touching the skin. Here are some key points about this new development:

- **Benefits**: The TIES Solution aims to eliminate the need for continual pouch wear and reduce skin complications.

- **Current Status**: It has received a CE mark (Class IIb) but is not yet marketed. Currently, it is limited to permanent ileostomies, with studies underway for colostomy use.

- **Trials**: There are ongoing multicenter studies in Sweden and the UK, involving several doctors.

- **Further Information**: More details can be found on the OstomyCure website.

Additional insights and advice from the community include:

- **Readiness and Evidence**: Discussions about TIES began in 2019, but the lack of commercial release suggests more work is needed. No feedback from UK trial participants has been shared yet.

- **Functionality Concerns**: For ileostomies, the absence of a pouch means small bowel output must be drained immediately to avoid pressure and bloating. Frequent cap opening may be necessary, and there are concerns about the rigid cap catching on clothing or equipment.

- **Suitability**: The system might be more suitable for colostomy patients who have a colon reservoir. It is not recommended for those with Crohn’s disease due to higher complication rates.

- **Materials and Construction**: The implant uses a titanium mesh that allows skin to grow through it, creating a seal. While titanium is biocompatible, there are concerns due to past litigations over surgical meshes.

- **Alternative Management Methods**: Regular colostomy irrigation can allow users to wear a stoma plug or small cap, eliminating the need for bags for 24-48 hours. Tips for successful irrigation include maintaining a regular schedule, experimenting with water volume and temperature, and being patient as habitual emptying may take time.

- **Bowel Transplantation Discussion**: While technically possible, bowel transplantation is costly and usually covered by insurers only in life-saving situations. Future hopes include advances like 3-D printed or lab-grown intestines.

- **General Sentiment**: The community is open to innovation but emphasizes the need to balance potential benefits against mechanical risks. Until more long-term data is available, many prefer existing options like conventional pouches, irrigation with stoma plugs, or waiting for improvements to the TIES system.