Ileal Pouch Surgery (J-Pouch)

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Ileal pouch surgery is a highly specialized procedure in which a patient’s colon and rectum are completely removed. The rectum is then replaced by connecting a piece of the patient’s small intestine to the anus, forming a J-shaped “pouch” through which waste is eliminated.

Ileal Pouch: A Highly Specialized Procedure

Ileal pouch surgery requires a high level of skill and experience in colorectal or colon surgery. UVA has two board-certified colon and rectal surgeons highly trained to do this procedure.

Who Should Have Ileal Pouch Surgery?

Candidates for ileal pouch surgery include patients with:

  • Ulcerative colitis that is not responding to medical therapies
  • Familial adenomatous polyposis (FAP)

Benefits of the Ileal Pouch

Ileal pouch surgery eliminates the need for a permanent ostomy bag since the rectum is recreated using the patient’s own small intestine. This allows the patient’s intestinal continuity to be restored so that evacuation of stool remains through the anus.

In many cases, ileal pouch surgery can be performed using minimally invasive laparoscopic surgery, which uses smaller incisions than traditional surgery and can result in less pain and a quicker recovery.

Before the Surgery

Patients must complete a series of tests before being designated as a candidate for ileal pouch surgery. A doctor will perform an exam to rule out Crohn’s disease, and the patient will be required to have a colonoscopy.

Patients must go without food for 24 hours before the surgery. They will also need to complete a cleansing prep to empty the bowel completely.


Weeks after the surgery when the pouch is completely healed the surgeon will undo the ileostomy, which is a temporary opening in the abdomen where digestive waste can leave the body. The patient will then be able to pass bowel movements through the anus. The new pouch is held together using titanium staples, which remain in the patient’s body permanently.


Ileal pouch surgery is a very effective treatment for ulcerative colitis and FAP, with a success rate of 90%.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.