UC to J-Pouch Story

Most FAQS: Two-Step Surgery

Posted by Megan on June 20, 2008

There are many questions about what “type” of surgery Mark had.  We will try to explain below, however, there are many options and many reasons for those options. 

Mark had a two step surgery.  Mark’s Step 1 surgery was a laproscopic total proctocolectomy with ileoanal reservoir reconstruction or in doctor talk Ileal Pouch Anal Anastomosis (IPAA) or Ileoanal anastomosis (J-POUCH to us common folks). with a temporary loop ileostomy until the jpouch heals (’takedown’ is 2nd surgery).   See J-Pouch Illustrated to understand how the temp ileo works until takedown is done.  His surgery time frame were:

July 2007 – lapro IPAA.

July-October – Lived with Temporary Ileo.

October 2007 – Takedown surgery, temp ileo gone.

We are asked to clarify why it seems the U.K. and U.S. do surgeries different. We don’t have the technical reason, but this is how we explain it when asked:  I’m not sure in the U.K. why it is done in so many steps. I do know in the U.S. that some people have one step, two step or three step depending on their health status (really sick people have 3 steps b/c their health can’t handle the more advanced surgery all at once so they do it in pieces to help the body heal).  Also, doctors do the steps via what their training is and what they are comfortable doing. Here we have two camps: surgeons that do lapro and those that do open surgery.  Since we’ve had some international attention to the blog, we’ve learned that the surgeries although the same really do vary between countries.

 Photo via: J-Pouch Illustrated 


5 Responses to “Most FAQS: Two-Step Surgery”

  1. JM said

    To be fair the main differences between the UK and the US seems to be that 1 step surgery is more common in the US, while this is done in the UK it is not common. It’s possible the different ways that our health care is provided may have something to do with this but I don’t know for sure. Three step surgery is most common when the patients health is poor and two step is common when the surgery is planned (mine was done this way), though an individual surgeons preferences do have a bearing on this too.

    Laparoscopic surgery is becoming more common place in the UK. Oxford’s Radcliffe Hopsital, one of our leading centres do most of theirs this way now as their studies have shown good long term benefits as well as the expected shorter term ones.

  2. Megan said

    This is great information, thanks for adding it to the site. That would make sense about health care being different. Do you know how many people in the UK have IBD?

  3. JM said

    In the UK it is estimated that about 1 person in 400 has IBD which gives about 150000. The ratio of UC to CD is about 2:1. There are about 25000 people with ileostomies, about 3 times this figure for colostomies and figures for internal pouches vary from 3000-5000.

  4. mdhilton said


    Thanks for sharing that info. Don’t quote me on this, but as far as I know there are about 3 Million people with IBD in the USA, and about 500,000 with UC (my ex-disease). I should find out how many people in the USA have j-pouches. I know my hospital did about 300 j-pouches per year.

  5. JM said

    3 million is much higher than the figures I’ve seen in the past, I normally see figures of about 1 million split evenly between UC and CD – which fits in with your figures for UC. The CCFA have some useful info at http://www.ccfa.org/info/about/ucp.

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