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Description keyboard_arrow_down
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