Total Proctocolectomy with End Ileostomy
Complete removal of the colon and rectum with a permanent ileostomy - the definitive surgical cure for ulcerative colitis when J-Pouch reconstruction is not appropriate due to sphincter function, dysplasia pattern, or patient preference.
What is Total Proctocolectomy with End Ileostomy?
Total Proctocolectomy with End Ileostomy involves removing the entire colon and rectum and creating a permanent ileostomy through which all faecal output is collected in a stoma appliance. Unlike the J-Pouch procedure, no internal reservoir is created - the ileostomy is permanent. Dr. Samhitha Reddy performs total proctocolectomy with end ileostomy at Lux Hospitals, Hyderabad for ulcerative colitis patients where J-Pouch surgery is not appropriate - due to poor sphincter function (which would result in poor pouch continence), a dysplasia pattern requiring complete sphincter excision, low rectal cancer, or patient preference for a simpler, single-stage curative operation. As part of the comprehensive ulcerative colitis specialist in Hyderabad programme, it provides definitive cure with reliable outcomes.
How the Procedure Works
Pre-operative Assessment
Colonoscopy, MRI pelvis, sphincter function assessment, and stoma siting by the stomal therapist are completed pre-operatively.
Laparoscopic Colectomy
The colon is mobilised and resected laparoscopically - from the terminal ileum to the rectum. The mesentery is divided systematically.
Proctectomy
The rectum and anus are dissected and excised - either with sphincter preservation (intersphinteric plane) or abdominoperineal resection depending on indication.
End Ileostomy Creation
The terminal ileum is brought through a carefully sited opening in the right lower quadrant of the abdomen and matured as an end ileostomy.
Stomal Therapy Education
The specialist stomal therapy nurse provides comprehensive training on stoma care, appliance management, and dietary guidance before discharge.
Outcomes
Who Needs This Treatment?
- →Provides permanent, definitive cure for ulcerative colitis - disease completely eliminated
- →Single-stage option - simpler than the 2-3 stage J-Pouch approach
- →No risk of pouchitis - the commonest J-Pouch complication
- →Appropriate when sphincter function is poor and pouch continence cannot be assured
- →Modern stoma appliances are discreet and manageable - excellent quality of life achievable
- →Available at Lux Hospitals, Hyderabad with specialist stomal therapy support
Total proctocolectomy with end ileostomy is a true cure - the disease is gone. And while a permanent ileostomy requires adjustment, many patients are genuinely surprised by how well-managed and unobtrusive modern stoma appliances are. Freedom from chronic colitis often far outweighs the adaptation.
— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon
Common Questions
Frequently Asked
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