RT Book, Section
A1 Mishra, Nitin
A1 Saleem, Abdulaziz M.
SR Print(0)
ID 1204542947
T1 Laparoscopic Proctectomy and Creation of Ileal Pouch Anal Anastomosis
T2 Handbook of Minimally Invasive Colorectal Surgery
YR 2024
FD 2024
PB McGraw Hill
PP New York, NY
SN 9781260142853
LK accesssurgery.mhmedical.com/content.aspx?aid=1204542947
RD 2024/09/10
AB Ileal  pouch  anal  anastomosis  (IPAA)  is  the  procedure  of  choice  for  restorative  proctocolectomy.  It  is  most  commonly  performed  in  cases  of  ulcerative  colitis  (UC)  or  familial  adenomatous  polyposis  (FAP).  In  UC,  the  operation  is  often  done  in  three  stages,  where  the  first  operation  will  be  the  total  abdominal  colectomy  with  end  ileostomy  in  patients  who  have  severe  disease,  are  malnourished,  or  are  on  a  high  dose  of  steroids  or  biologics.  The  second  stage  is  done  four  to  six  months  after  the  first  operation.  This  allows  the  patient  to  recover  from  the  first  operation,  regain  their  nutritional  status,  and  stop  the  biologics  and  steroids.  The  second  stage  includes  proctectomy,  with  the  creation  of  the  IPAA,  and  creation  of  the  diverting  loop  ileostomy.  The  third  stage  is  closure  of  the  loop  ileostomy.  In  this  chapter,  we  describe  the  second  stage  of  a  three-stage  pouch  surgery,  performed  laparoscopically.