Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is today considered the gold standard and, in experienced hands, can now be performed safely for UC with a low postoperative complication rate and a long-term pouch failure rate reported less than 10%6-8.
The introduction of minimally invasive techniques might further decrease postoperative morbidity and improve patients’ satisfaction, with reduced impact on body image and better cosmesis9-11. Unfortunately not every patient is a candidate for a restorative operation and, like in the case of our patient, a total proctocolectomy (TPC) with a permanent Brook ileostomy is performed with a laparoscopic approach.
Laparoscopic TPC offers significant advantages over the open conventional procedure in terms of body image and cosmesis, important factors in the acceptance of surgery in this young patient population, while conflicting results have been reported in terms of postoperative recovery. Faster return of bowel function after laparoscopy and decreased use of narcotics have been reported by some authors, not always translating into shorter hospital stay.
DOI: http://dx.doi.org/10.17797/ukm5thekea
Editor Recruited By: Jeffrey B. Matthews, MD
Totally Laparoscopic Total Proctocolectomy
Ulcerative Colitis; Crohn's Disease; FAP
Obesity, Intraabdominal adhesion
N/A
Colonoscopy
N/A
Faster return of bowel function
injury to the ureter; bleeding
injury to the ureter; bleeding
N/A
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Disclosure/ Conflict of interest: The authors whose names are listed above certify that they have NO affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers ’bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
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