Total proctocolectomy and ileal - anal pouch

Alternative Names: Restorative proctocolectomy; Ileal-anal resection; Ileal-anal pouch; J-pouch; S-pouch; Pelvic pouch; Ileal-anal pouch; Ileal pouch-anal anastomosis; IPAA; Ileal-anal reservoir surgery

Total proctocolectomy and ileal-anal pouch surgery is the removal of the large intestine and most of the rectum. The surgery is done in one or two stages.

Description of Procedure

You will receive general anesthesia right before your surgery. This will make you unconscious and unable to feel pain.

You may have the procedure in one or two stages:

• Your surgeon will make a surgical cut in your belly. Then your surgeon will remove your large intestine.
• Next your surgeon will remove your rectum. Your anus and anal sphincter (the muscle that opens your anus when you have a bowel movement) will be left in place.
• Then your surgeon will make a pouch out of the last 1 1/2 feet of your small intestine. The pouch is sewn to your anus.

If you have an ileostomy, your surgeon will close it during the last stage of the surgery.

Risks of Total proctocolectomy and ileal - anal pouch

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Heart attack or stroke
• Infection, including in the lungs, urinary tract, and belly

Risks for this surgery include:

• Bleeding inside your belly
• Bulging tissue through the cut, called an incisional hernia
• Damage to nearby organs in the body and nerves in the pelvis
• Scar tissue that forms in the belly and causes a blockage of the small intestine
• The place where the small intestine is sewn to the anus may come open (anastomosis), which can be life threatening
• Wound breaks open
• Wound infections

Review Date: 11/23/2010
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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