Avoiding ileocolic vessel injury in the second stage of a three-stage ileal pouch anal anastomosis: an observational study | ||
| The Egyptian Journal of Surgery | ||
| Article 6, Volume 36, Issue 1, January 2017 PDF (1.25 M) | ||
| DOI: 10.4103/1110-1121.199887 | ||
| Authors | ||
| Ahmed A. Abou-Zeid; Islam Hossam El-Din El-Abbassy; Ahmed A. Khalil; Mahmoud Farghaly; Sherif Boraei | ||
| Abstract | ||
| Ileal pouch anal anastomosis is a commonly performed procedure. The operation can be completed in one stage, two stages, or three stages depending on the general condition of the patient and the local condition of the bowel. The J pouch is the most commonly performed pouch design. After construction, the pouch mesentery can be short, necessitating ligation and division of the superior mesenteric pedicel to allow the pouch reach the anal canal at ease. In this case, the ileocolic pedicle should be intact to give alternative blood supply to the newly constructed pouch. The ileocolic pedicle can be inadvertently injured during dissection to take down the ileostomy in the second stage of a three-stage operation. This can risk the pouch integrity in case the superior mesenteric pedicle needs to be divided. We are describing a method to avoid such inadvertent ileocolic vessel injury. After adopting this method, we did not have a single incident of ileocolic vessel injury in the second stage of a three-stage ileal pouch anal anastomosis. | ||
| Keywords | ||
| ileal pouch; ileocolic; J pouch | ||
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