This presentation is a contribution from Dr. Jatin Bhatt, Professor & HOD, Department of Surgery, PDU Medical College, Rajkot.

5. IPAA: Preoperative Counseling If the patient is fit, understands the less than perfect outcome, and still desires to have the procedure, it should be considered.

6. Barium Enema

7. Endoscopic View

9. Mobilisation of Ileum: Dissection till root of SMV (pancreas) ICV ligated, Serosal incisions

10. Different Pouches S Pouch J Pouch W Pouch

11. Operative Steps (J-Pouch)

12. Linear Cutter 55

13. Stapling Technique:

14. J Pouch

16. Linear Stapler 60

17. Rectal Transection 5cm from anus

18. Stapled Rectal Stump

19. End to End Anastomosis (EEA) Stapler 29

20. Technique of EEA

21. Anvil placed at the apex of J pouch with purse string sutures

22. Stapler introducer P/R

24. Both ends are joined

25. Stapler closed & fired

26. Both Doughnuts

28. AIM End Result

29. Case-1 Case-2

31. Case-1 Case-2

36. THANKS