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Laparoscopic Total Proctocolectomy + TaTME with J- pouch Reconstruction
Dr. Antonio Caycedo performs a Laparoscopic Total Proctocolectomy + TaTME with J- pouch Reconstruction to a 22-year-old male.
Technique Description:
- 1. Laparoscopic proctocolectomy (medial-to-lateral approach)
- 2. TaTME
- 3. J-pouch creation
- 3. Diverting loop ileostomy
Procedure Steps:
- 1. Splenic flexure takedown
- 2. Right colon dissection
- 3. Transverse colon dissection
- 4. Left colon dissection
- 5. Pelvic dissection
- 6. Trans-anal "disconnection"
- 7. Division of terminal ileum
- 8. Trans-anal extraction
- 9. J-Pouch construction
- 10. Hand-sewn anastomosis
Learning Points:
- Medial to lateral dissection
- Landmarks recognition
- TaTME purse-string troubleshooting
- Intra-corporeal J-pouch creation
Clinical History:
- 22-year-old male, previously healthy
- 3 months’ history of frequent bloody BMS
- Found to have carpeting polyposis throughout his colon
- No family history of FAP or any genetic conditions
Other History:
- Investigations: Full colonoscopy: biopsies confirmed adenomatous polyps
