BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuTotal proctocolectomy and ileal-anal pouchRestorative proctocolectomy; Ileal-anal resection; Ileal-anal pouch; J-pouch; S-pouch; Pelvic pouch; Ileal-anal pouch; Ileal pouch-anal anastomosis; IPAA; Ileal-anal reservoir surgeryTotal 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 before your surgery. This will make you sleep and pain free.General anesthesiaGeneral anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...Read Article Now Book Mark Article You may have the procedure in one or two stages:Your surgeon will make a surgical cut in your belly. Then your surgeon will remove your large intestine. Next, your surgeon will remove your rectum. Your anus and anal sphincter will be left in place. The anal sphincter is the muscle that opens your anus when you have a bowel movement. Then your surgeon will make a pouch out of the last 12 inches (30 centimeters) of your small intestine. The pouch is sewn to your anus. 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:Ulcerative colitis Ulcerative colitisUlcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...Read Article Now Book Mark Article Familial polyposisFamilial polyposisA colorectal polyp is a growth on the lining of the colon or rectum.Read Article Now Book Mark Article Risks Risks of anesthesia and surgery in general are:Reactions to medicines Breathing problems Breathing problemsBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airRead Article Now Book Mark Article Bleeding, blood clots Blood clotsBlood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...Read Article Now Book Mark Article Infection Risks of having this surgery include:Bulging tissue through the cut, called an incisional hernia Incisional herniaA hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the be...Read Article Now Book Mark Article Damage to nearby organs in the body and nerves in the pelvis Scar tissue that forms in the belly and causes a blockage of the small intestine The place where the small intestine is sewn to the anus (anastomosis) may come open, causing infection or abscess, which can be life threatening AnastomosisAn anastomosis is a surgical connection between two structures. It usually means a connection that is created between tubular structures, such as bl...Read Article Now Book Mark Article Wound breaking open Wound infection 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:Intimacy and sexuality Pregnancy Sports Work During the 2 weeks before your surgery:Two weeks before surgery, you may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), Naprosyn (Aleve, Naproxen), and others. Ask which medicines you should still take on the day of your surgery. If you smoke, try to stop. Ask your provider for help. Try to stopThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...Read Article Now Book Mark Article Always let your provider know about any cold, flu, fever, herpes breakout, or other illnesses you may have before your surgery. ColdThe common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....Read Article Now Book Mark Article FluThe flu is an infection of the nose, throat, and lungs. It spreads easily. This article discusses influenza types A and B. Another type of the flu ...Read Article Now Book Mark Article FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...Read Article Now Book Mark Article The day before your surgery:You may be asked to drink only clear liquids, such as broth, clear juice, and water after a certain time. Follow the instructions you have been given about when to stop eating and drinking. You may need to use enemas or laxatives to clear out your intestines. Your provider will give you instructions on how to use them. On the day of your surgery:Take the medicines you have been told to take with a small sip of water. You will be told when to arrive at the hospital. 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.Open ReferencesReferencesMahmoud 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.Raza A, Araghizadeh F. Ileostomies, colostomies, pouches, and anastomoses. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 117.AllVideoImagesTogA Closer Look Ulcerative colitis(In-Depth)Related Information Ileostomy(Surgery)Total abdominal colectomy(Surgery)Total proctocolectomy with ileostomy (Surgery)Crohn disease(Condition)Ulcerative colitis(Condition)Colorectal cancer(Condition)Colorectal polyps(Condition)Ileostomy and your child(Self-Care)Ileostomy and your diet(Self-Care)Ileostomy - caring for your stoma(Self-Care)Types of ileostomy(Self-Care)Ileostomy - discharge(Discharge)Living with your ileostomy(Self-Care)Bland diet(Self-Care)Ileostomy - changing your pouch(Self-Care)Total colectomy or proctocolectomy - discharge(Discharge)Low-fiber diet(Self-Care)Ulcerative colitis(In-Depth) Review Date: 9/28/2020 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. 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. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.