Laparoscopic Restorative Proctocolectomy for Ulcerative Colitis - How I Do It?

Total proctocolectomy with ileal pouch anal anastomosis (IPAA) is nowadays the gold standard in patients with ulcerative colitis requiring surgery. It is a complex procedure, being associated with a significant rate of morbidity and mortality. In order to obtain better results, the timing of surgery is essential. In the last decades, with the expansion of the minimally invasive techniques, the procedure can be performed feasible and safe by laparoscopy, bringing all the short term advantages associated with this approach. Due to the long term advantages regarding improved female fecundity function and fewer adhesions the laparoscopic approach is now recommended by the European Crohn's and Colitis Organization in centers with appropriate expertise.