The purpose of this study was to describe our minimally invasive technique and outline perioperative and medium-term outcomes in patients undergoing laparoscopic
ileal pouch-anal anastomosis (LIPAA) for
ulcerative colitis. Data were obtained from a prospectively collected database of 13 LIPPA procedures performed for
ulcerative colitis between May 1994 and November 2000. Medium-term quality-of-life follow-up was obtained by telephone interview. Eight males and five females had an LIPAA performed, all of whom had previously undergone total abdominal
colectomy with
ileostomy. Median
operative time was 255 minutes (range, 200-398 minutes) with one conversion (8%) due to adhesions. There were no deaths or
intraoperative complications; however, six patients experienced seven postoperative complications within 30 days of final closure of defunctioning
ileostomy (two leaks, two
wound infections, one pulmonary
embolus, and two reoperations for small bowel obstruction). Median
length of stay was 7 days (range, 5-13 days). Median follow-up was 24 months (range, 6-66 months). The median number of day and night bowel movements was 6.0 (range, 3-10) and 1.0 (range, 0-3), respectively, with five patients requiring medication to control frequency. None had incontinence of stool or
retrograde ejaculation; however, one had occasional incontinence of gas, three had occasional nocturnal soiling, and one was impotent. Three patients (23%) had
pouchitis, all treated successfully with oral
antibiotics. All patients were satisfied with the outcome of their operation and all preferred their pouch to previous
ileostomy. Patients reported their overall social, emotional, and physical well being to be satisfactory to excellent. Results of the SF-36, a generic quality-of-life survey, were similar to those from studies of patients following an open pelvic pouch procedure. The LIPAA is technically feasible in experienced centers. We believe that the technique is still evolving and that more time and experience is required to refine the procedure.