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Updated: Aug 22, 2026

Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Surgical treatment and role of dynamic defecography after ileal pouch-anal anastomosis: technical solutions to a
R Silvis1, J B Delemarre, H G Gooszen
1Department of Surgery, University Hospital Utrecht, The Netherlands.
Purpose:
Patients with an ileal pouch-anal anastomosis may develop impaired evacuation of the pouch. A new surgical approach and the role of dynamic defecography in such patients are highlighted.
Methods:
Five patients with ileal pouch-anal anastomosis were assessed clinically and with dynamic defecography before and after reoperation.
Results:
In one patient an extensive approach with complete pouch mobilization, stenoplasty of a pouch outlet stenosis, shortening of the rectal remnant, and renewed pouch-anal anastomosis were needed; in three patients, a long and angulated efferent limb was shortened by transabdominal techniques (stenoplasty or a newly developed technique with a linear stapler), and in one patient a pouch inlet stenosis was corrected. In all patients, impaired emptying was cured; in all patients, obstructive abdominal pain improved considerably.
Conclusions:
Dynamic defecography is indispensable for tailoring surgical treatment. Effective transabdominal shortening of the efferent limb can be performed with the aid of a linear stapler.
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