Laparoscopic Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis for Ulcerative Colitis: A Quantum Shift in Surgical Care?

Category: Inflammatory Bowel Disease

Aims: Restorative proctocolectomy and ileal pouch anal anastomosis for ulcerative colitis traditionally involves a large surgical incision, significant morbidity and prolonged inpatient stay (17.37 days, DOH 2003). We present a video demonstration of this surgery performed laparoscopically in a tertiary referral specialised colorectal unit.

Methods: A single live case digitalised recording was performed and edited to presentation length DVD format.

Results: A 25 year old female with a 10 year history of ulcerative colitis that was refractory to medical therapy was referred for surgical management. Her body mass index (BMI) was 21.7kg/m2. She underwent a laparoscopic restorative proctoctocolectomy with ileal pouch – anal anastomosis and a defunctioning loop Ileostomy in January 2006. She followed the RAPID recovery protocol. She was discharged home well on the eight post operative day. The operative time was 300 minutes and maximum incision length was 8cm. A DVD of the operative technique is presented.

Conclusions: Laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis for Ulcerative colitis is technically feasible and it offers patients a minimally invasive approach for this complex surgery. We are unaware of any previous reports of this surgery being performed laparoscopically in this country.