J-Pouch Surgical Break Down

I have had many friends and family ask me about my surgeries, and to spare them the experience of seeing the horrifying images on Google, I have done my best to explain all three stages of my surgeries. For some j-pouch patients surgeries #1 and #2 can be done in one surgery, but due to the severity of my UC at the time of my first surgery, Dr. Hurst thought it best to extend the process to three stages.

Surgery #1- Total Abdominal Colectomy with Hartmann’s pouch (colon removal +  end ileostomy)

Think back to learning the digestive system in biology class- the colon is what you think of as the large intestine, but medically speaking the large intestine includes the cecum, appendix, colon, rectum, and anal canal.  During my first surgery, Dr. Hurst removed my colon and appendix, but left the rectum. These images might help.


(This one better shows the stoma, also I kind of like the phantom colon)


Surgery #2- Laparoscopic Restorative Proctectomy with Ileal Pouch-Anal Anastomosis + Diverting Loop Ileostomy (J-pouch + mid ileostomy)

This was the “big one” I had done in July 2013. I am currently living with my J-pouch fully constructed and waiting for it to heal. During the three month mandatory healing period I am not using my j-pouch, which is where the diverting ileostomy comes into play. This, as many of you know, has been a more difficult healing process than I experienced with surgery #1. This ileostomy is further up on my small intestine because the end has been stretched down to form the j-pouch and connected to my newly re-built rectum ( let me tell you that experience was just about as fun as it sounds). With the higher ileostomy nutrients and fluids don’t have as much time to be absorbed, but soon I will be back to using my full 23 feet 4 inches (approx.) of small intestine for absorption.

(The top right image shows the j-pouch with diverting ileostomy)


(These bottom images show what my digestive system will look like after surgery #3)

Surgery #3- Ileostomy Take Down (closing of stoma and skin opening)

This is the surgery I am waiting for. It is the last stage of my journey to living with a j-pouch. The “Take Down” is a simple surgery when compared to the first two.  Dr. Hurst will reverse my ileostomy and I will start to use the j-pouch. I will be able to give more insight into this surgery in November.


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