J-pouch surgery, also called IPAA (ileal pouch-anal anastomosis) is necessary when medications fail to control the symptoms of those suffering from ulcerative colitis. Although it is most often employed to treat chronic ulcerative colitis, it may also be utilized if patients have familial adenomatous polyposis (a genetic disorder that results in hundreds to thousands of colon polyps). Ultimately, this surgery enables the patient to eliminate waste normally after removal of the entire large intestine.
J-Pouch Surgical Process
The surgery is done in 2 or 3 stages. If doing a 2-stage procedure, stages 1 and 2 are combined with a temporary diverting loop ileostomy.
- Stage 1: Robotic total abdominal colectomy with end ileostomy – This removes the entire colon. The rectum remains in place and the ileum of the small intestine is brought out as a temporary ileostomy. The minimal amount of time between procedures is 3 months.
- Stage 2: Robotic proctocolectomy with creation of the J-pouch – The rectum is removed, and the J- pouch is created from the ileum of the small intestine and attached to the anus. A temporary loop ileostomy will be created to allow the J-pouch time to heal.
- Stage 3: Ileostomy reversal – The ileostomy is reversed so that waste can eliminate through the normal anus. At Colorectal Surgical Associates, we use the da Vinci® minimally invasive robotic surgical system to substantially reduce the size of the incision, risk of infection, length of hospital stay, and recovery time. The da Vinci method also offers improved healing and reduced scarring. Dexterity and control are maximized using robotics for a minimally invasive approach to the surgical procedure.
Risk of J-Pouch Surgery
J-pouch surgery carries some risks, including ileostomy blockage, dehydration, diarrhea, stricture (narrowing of the area between the pouch and anus), pouch failure, and inflammation of the internal pouch (pouchitis). Antibiotics are usually used to treat pouchitis. After surgery, the patient will be able to eliminate on the toilet. Bathroom visits may be frequent, but not as much as before surgery. Some discover they can eat more foods than before surgery.