Last updated: 02/17/2009

Conventional ileoanal reservoir surgery is an open procedure that is done in two stages. In the first stage, the surgeon removes the diseased colon and creates a pouch. The second stage is performed three months later, when the temporary drainage conduit...

is closed and the newly created reservoir allows the patient to defecate in the normal fashion. Both surgeries can also be done together, bypassing the creation of a temporary ileostomy.

Some surgeons use a laparoscopic approach to ileoanal surgery. This technique involves the insertion of scaled-down surgical instruments and a scope that allows the surgeon to see inside the abdomen through several relatively small incisions (3.5 inches [9 cm] or about compared to 6.3 inches [16 cm] or for an open procedure) in the abdominal wall. Studies indicate that there are few differences in the rates of mortality or complications between laparoscopic surgery and conventional open surgery. Because the incisions are smaller, patients typically require less pain medication with laparoscopic surgery.

Ileoanal surgery includes the following steps:

• The surgeon isolates the ileum or small segment of bowel.
• The segment is then attached to the anus with absorbable sutures.
• A pouch is created out of the small bowel above the anus.
• If the surgeon is performing the procedure in two stages, he or she creates a temporary ileostomy. An ileostomy is a tubular bowel segment attached to a stoma at the abdomen that drains into a bag outside the abdomen.
• In the second-stage operation, the surgeon uses an open abdominal procedure to close the temporary pouch.

The surgeon will insert stents to bypass the surgical site and divert urinary and digestive wastes to the outside of the body, thus allowing the new connection between the ileum and the anus to heal properly.