How do I perform pouch surgery? |
This is a major procedure which can be performed in a number of ways. Here is what I currently do.
I start by dissecting out the last part of the large bowel, called the rectum, through the anus. This part of the procedure is performed with the child on their front.
The patient is then turned onto their back, allowing us to insert telescope and instruments through small holes, which we call ports.
The entire colon is dissected and removed, either through the anus or through a small incision.
I make a pouch using a special surgical stapler, then pass this through the pelvis to join it to the anus with sutures.
In adult patients the pouch is usually stapled to the anus, but this is difficult to do correctly in children because of their small pelvis.
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This operation is usually broken down into stages. We can either perform two or three stages, but I always leave my patients with a temporary stoma until the pouch has healed to the anus. In practice this means the child has a bag for 6 weeks. If a child is seriously ill, I may just remove the colon as a first stage, allowing the child to recover from the illness before completing the surgery some months later, in a further two stages. |
