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Total proctocolectomy and ileal-anal pouch

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.

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Description

You will receive general anesthesia before your surgery. This will make you sleep and pain free.

You may have the procedure in one or two stages:

Some surgeons perform this operation using a camera. This surgery is called laparoscopy. It is done with a few small surgical cuts. Sometimes a larger cut is made so the surgeon can assist by hand. The advantages of this surgery are a faster recovery, less pain, and only a few small cuts.

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

Why the Procedure Is Performed

This procedure may be done for:

Risks

Risks of anesthesia and surgery in general are:

Risks of having this surgery include:

Before the Procedure

Always tell your health care provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.

Before you have surgery, talk with your provider about the following things:

During the 2 weeks before your surgery:

The day before your surgery:

On the day of your surgery:

After the Procedure

You will be in the hospital for 3 to 7 days. By the second day, you will most likely be able to drink clear liquids. You will be able to add thicker fluids and then soft foods to your diet as your bowel begins to work again.

While you are in the hospital for the first stage of your surgery, you will learn how to care for your ileostomy.

Outlook (Prognosis)

You will probably have 4 to 8 bowel movements a day after this surgery. You will need to adjust your lifestyle for this.

Most people recover fully. They are able to do most activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.

Related Information

Ileostomy
Total abdominal colectomy
Total proctocolectomy with ileostomy
Crohn disease
Ulcerative colitis
Colon and rectal cancer
Colorectal polyps
Ileostomy and your child
Ileostomy and your diet
Ileostomy - caring for your stoma
Types of ileostomy
Ileostomy - discharge
Living with your ileostomy
Bland diet
Ileostomy - changing your pouch
Total colectomy or proctocolectomy - discharge
Low-fiber diet
Ulcerative colitis - discharge
Ileostomy - what to ask your doctor

References

Araghizadeh F. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 117.

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 51.

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Review Date: 9/3/2018  

Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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