An Overview Of J-Pouch Surgery

A patient may have to undergo j-pouch surgery after having a proctocolectomy. A proctocolectomy is a surgical procedure involving the removal of the colon and rectum. The surgeon may choose to perform this operation when the colon and rectum are severely infected due to a medical condition. That medical condition can be chronic ulcerative colitis, colorectal cancer, or familial adenomatous polyposis.

A j-pouch provides an alternate way to store and expel wastes through the anus after the removal of the colon and rectum. The procedure to create a j-pouch is also known as the ileal pouch-anal anastomosis (IPAA). It involves the creation of a pouch by folding the small intestine into itself. The joined sides of the fold are sutured to give it the shape and functionality that of a pouch. The surgeon then fits this pouch over the anal canal to allow it to pass stools to the anal sphincters.

There are three types of an ileal pouch: j-pouch, s-pouch, and w-pouch. The j-pouch is the most well-known type as it needs the shortest length of the small intestine.

You can qualify to have an ileal pouch if your intestinal muscles, nerves, and anal sphincters are fit enough to help you control when to expel bodily wastes. Your doctor will see if you are a candidate for ileal pouch surgery. The factors he may look for during the analysis may include the following.

• If you have Crohn’s disease, IBD-unclassified, or indeterminate colitis, you may not be a candidate for a j-pouch.
• Obesity is another hurdle in the way of creating an ileal pouch. The surgery time will be longer if you an obese person, meaning that the surgeon will have an overall difficulty constructing an ileal reservoir. Your doctor may recommend you lose weight before surgery.
• If your anal sphincters are not fit enough to function, you may not be able to get an ileoanal reservoir or j-pouch.

The surgical procedure involved in the creation of a j-pouch

There can be one, two, or three stages involved in the construction of a j-pouch. This number of stages depends on the condition and overall health of the patient.

The surgeon creates a j-pouch by making two loops of the small intestine, with each loop measuring six inches in length. Then he fits this reservoir over the top of the anal canal, allowing this canal to act as a medium to pass stools out through the anus.

The j-pouch needs some time to heal, so the surgeon creates an opening in the abdomen to allow bodily wastes to leave the body without proceeding to the newly constructed j-pouch. You are going to need to wear an ostomy bag over the stoma to manage stool evacuations.

After the j-pouch heals, the surgeon reconnects the bowel by closing the ileostomy. After this, the patient can get rid of bodily wastes through the anus.

The benefits of j-pouch surgery

J-pouch surgery aims to treat severe bowel conditions such as colitis and familial adenomatous polyposis while helping the patient to retain the ability to expel wastes through the anus. It can be a significant psychological advantage eventually.