Includes: Sterile Loop Ostomy System, Contains 1 Extra-Large Stomahesive Skin Barriers Without Tape Collar, 1 14" Straight, Transparent, Drainable Pouch, 1 Tail Closure And 1 3 " Loop Ostomy Rod, Extra-Large Up To 89mm (3 1/2'') Stoma. Esteem synergy Professional Kits. The Esteem synergy ostomy system utilizes an innovative Adhesive Coupling Technology that connects the pouch to the skin barrier and eliminates the need for plastic rings that must be snapped or locked together. Instead of a plastic ring, Esteem synergy pouches feature a flat, flexible adhesive foam ring that securely connects to a flexible, clear landing zone" on the skin barrier. The result is a low-profile, flexible two-piece system.