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Indications and Surgical Technique for Transanal Proctectomy and Ileal Pouch-Anal Anastomosis for Inflammatory Bowel

Andrew Yuen1, Mantaj S Brar1, Anthony de Buck van Overstraeten1

  • 1Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Clinics in Colon and Rectal Surgery
|March 3, 2022
PubMed

Surgical management of inflammatory bowel disease has advanced significantly over the years. One particular focus of its evolution has been to minimize invasiveness. Transanal surgery has given the contemporary surgeon an alternate approach to access the low rectum situated in the confines of the deep pelvis. In benign disease, combining transanal surgery with laparoscopy has allowed for the development of novel techniques to create ileal pouch-anal anastomoses, perform intersphincteric Crohn's proctectomies, manage complications from pelvic surgery, and facilitate redo pelvic surgery. We aim to review the indications for transanal surgery in benign disease, describe an approach to transanal pouch surgery in detail, and discuss the potential benefits, pitfalls, and contentious issues surrounding this approach.

Keywords:
close rectal dissectionileal pouch–anal anastomosisinflammatory bowel diseaseproctectomytransanal

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