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
