IPAA

J pouch:

• Check length, taking into account the natural lowest point of the ileum to use this as the apex for the pouch
• Aim for 15cm pouch
• Enterotomy at apex
• Aim for 3 firings of a GIA blue, careful to exclude mesentery
• Secure anvil
• Fire EEA stapler from below, being very careful of mesenteric alignment
• Pouch can sit either anteriorly or posteriorly
• Anastomosis

Complications

• Infertility
  • 48% of women are unable to fall pregnant after 12 months of trying after IPAA, compared with 15% of patients with UC prior to IPAA
  • The most important factor is probably adhesions