Ask the Expert

Get answers to your GI cancer surgery questions.

Note: This is for informational purposes only. Doctors cannot provide a diagnosis or individual treatment advice via e-mail. Please consult your physician about your specific health care concerns.

Please install flash player to see this video.

Total proctocolectomy and ileal - anal pouch - Overview

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

Definition of Total proctocolectomy and ileal - anal pouch:

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:

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

During the first stage of surgery:

Your surgeon will make an incision (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.

In the second stage of surgery, you will often have a small cut made in the wall of your belly for an ileostomy. It is usually placed in the lower right part of your belly. The ileum is brought up to this spot and sewn into the abdominal wall.

If you have an ileostomy, your surgeon will close it later in a shorter surgery.

Why the Procedure Is Performed:

This procedure may be done for:

Reviewed last on: 1/26/2009
Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Cima RR, Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 110.

Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 50.

Khatri VP, Asensio JA, eds. Subtotal colectomy/panproctocolectomy and j-pouch reconstruction. Operative Surgery Manual. 1st Ed. Philadelphia, Pa: Saunders; 2003:chap 35.

Scriver G, Hyman N. Ileostomy construction. Operative Techniques in General Surgery. 2007;9(1): 43-49.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Home > Medical Reference > Encyclopedia (English)