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Preoperative Ileal-Pouch Anal Anastomosis – Tips and Pearls

 

Presented by Steven Wexner, MD at the SAGES 2014 Meeting; Pre-operative Pelvic Surgery, Benign and Malignant – What is the Big Deal


re-operative salvage surgery–39 sec
pouch failure–1:16
management of pouch failure: assessment–3:02
management of pouch failure: imaging–3:56
management of pouch failure: other investigations-


Keyword(s): abdominal cramps, abdominal mobilization, abdominal salvage surgery, abdominal/combined approach, abdominoperineal salvage operations, abscess, abscess cavity, abscess drainage, adhesions, afferent limb syndrome, afferent loop endoscopy, age, algorithim, American Journal of Gastroenterology, anal canal mucosectomy, anal transition zone, anal transitional zone, anal US, anastomotic dehiscence, anastomotic leak, anatomy, andenoma, anemia, Annals of Surgery, ano-rectal manometry, anoscopes, antianxiety meds, antidepressants, asymptomatic radiologic leak, benign, biologics, bone scan, British Journal of Surgery, bx, C difficile, capsule endoscopy, case reports, challenges, chronic pre-sacral leak, CMV infection, collaborative approach, Colorectal Diseases, conduit, contradindications, Crohns disease, CT, cuff endoscopy, cuff excision, cuffitis, curettage, currette, cutaneous pouch, cx, cysto, defects, definitive management, demographics, diarrhea, disease residual, Diseases of the Colon & Rectum, diverting loop ileostomy, double stapled pouches, double-stapled, duodenum, dx, dysplasia, efferent limb leak, efferent limb syndrome, end ileostomy, endo-sponge vacuum assisted drainage, endoscopic balloon dilatation, endoscopic findings, Endosponge, etiology, EUA, exam, excision of fistula, external hemorrhoids, failure rate, FAP, fecal urgency, female, fibrin glue, fibrostenotic, fibrotic, fistulae, fistulizing, fistulotomy, fitness level, follow-up, frozen pelvis, functional pouch failure, gangrene, gastroenterologist, gracilis interposition, hand-sewn pouch anal anastomosis, handsewn neo-ileal pouch anal anastomosis, healing, histological findings, hx, IBS, ileal pouch anal anastomosis stricture, ileal pouch failure, ileal pouch-anal anastomosis, ileal-anal pullthrough, ileal-pouch anal anastomosis, ileoanal anastomosis, ileocolic vessel, ileum, imaging, incidence, incontinence, indeterminate colitis, indications, individualized managment, infectious pouch failure, inflammatory polyps, intermediate arcade, IPAA stricture, IPS, J pouch procedures, J-pouch, J-pouch surgery, Jagelman/Turnbull International Colorectal Disease Symposium, lap, lap approach, laparoscopically, laparotomy, leak, learning curve, lengthening maneuvers, LIFT procedure, lithotomy, Lone-star retractor, loop ileostomy, loop ileostomy diversion, malignant, malnutrition, MCS, mechanical failure, mesenteric desmoid, mesenteric windows, MRI, mucle flap, muscle interposition, neoplasm, nighttime defecation, non-mucosectomy IPAA, nonoperative, observation, omentopexy, op report, open, open approach, osteomyelitis, outcome related, pathology slides, PE, pelvic discomfort, pelvic surgery, pelvis, peri-rectal drainage, perianal region, perineal approach, perineal pouch, peritoneum, permanent ileostomy, permanent ostomy, phenotypes, plug, postanal sinus, pouch, pouch advancement, pouch anal anastomosis, pouch compliance, pouch cutaneous fistula, pouch diseases, pouch excision, pouch exclusion, pouch failure, pouch failure manifestation, pouch inlet, pouch inlet stricture, pouch leak, pouch LI, pouch re-construction, pouch reconstruction, pouch repair, pouch revision, pouch rotation, pouch tension, pouch-anal anastomosis, pouch-vaginal fistula, pouchitis, pouchogram, pouchoscopy, pre-op stoma marking, pre-sacral abscess, preop dx, previous medical tx, prolapse, prone Jack knife, prostate, proximal superior mesenteric maneuvers, pseudo-obstruction, pt related, pt related factors, pt satisfaction, QOL, re-assess, re-do IPAA, re-image, re-operative salvage surgery, re-staple, rectal anastomosis, rectal columnar cuff, rectal stump, rectal tube, recurrent rectal cancer, reoperative, reoperative restorative proctocolectomy, residual colonic mucosa, residual sinus, restorative proctocolectomy, results, retained rectal mucosa, retained rectum, retrospective review, risk factors, sacral promontory, SB bacterial overgrowth, SB series, scarring, score, seminal vessicles, sepsis, septic complications, Seton placement, sinus tract, sperm-banking, sphincter damage, sphincter musculature integrity, sphincter status, sphincter tone, staple line, stapled anastomosis, steroids, stoma, stricture, subtypes, success rates, surgeon preference, surgical failure, surgical options, sx, systemic, T&C, take down, technical pouch failure, technical related, techniques & tips, Techniques in Coloproctology, tips & pearls, trans-anal disconnection, trans-IPAA drainage, transabdominal mobilization, transabdominal stricturoplasty, transanal approach, transanal completion mucosectomy, transanal pouch detachment, transanal repair, transanal vacuum drainage, translumination, twisted pouch, UC, ureteric catheters, urethral pouch, uretral stents, urgency, vaginal pouch, Vit B12 deficiency, volume, Xenon fiberoptic headlight

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Related

Video Uploaded By:
Steven Wexner
Uploaded on
09/12/2014
Video Categories
SAGES 2014 Meeting
Learning Themes
Colorectal
Sources
2014 Annual Meeting
Presentation Types
How-To, Podium Presentation
Video Authors
Wexner S
Video Institutions
Charles E Schmidt College of Medicine FAU--Boca Raton FL, Cleveland Clinic--Weston FL, Digestive Disease Center--Weston FL, Herbert Wertheim College of Medicine FIU--University Park FL

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