Technical Note


Techniques of laparoscopic total proctocolectomy and ileal pouch anal anastomosis patients with ulcerative colitis

Lei Lian

Abstract

The incidence of ulcerative colitis (UC) is increasing in adults and children worldwide. Despite the advances in drug therapy, surgery is also an important treatment. Total proctocolectomy (TPC) with ileal pouch anal anastomosis (IPAA) is the gold standard surgical treatment of UC since its introduction in 1978 by Parks and Nicholls. Laparoscopic TPC with IPAA, as a new approach for UC patients, has been applied and demonstrated to be feasible and safe. Similar to many other laparoscopic surgeries, laparoscopic TPC with IPAA benefits the patients with better outcomes in terms of cosmesis, pain and early recovery, especially in young patients. As for the surgeons, laparoscopy can provide a broad field of vision, which facilitates the surgery in the deep pelvic as well as with less tissue damage. In general, the surgery involves total colectomy, rectal dissection, pouch creation and anastomosis of pouch to the anal canal.

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