V71 - Robotic Proctectomy with Totally Intracorporeal Ileoanal J-Pouch Creation

Saturday, May 9, 2026

On-Demand

Video Presentation(s)

Sophia Zigouras, DO, MS, RD

Colon & Rectal Surgery Fellow
Rutgers Robert Wood Johnson
Rutgers RWJ
Jersey City, NJ, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Daniel L. Feingold, MD, FACS, FASCRS

Professor of Surgery
Rutgers University
New Brunswick, New Jersey, United States

Disclosure information not submitted.
Kristen Donohue, MD, FACS, FASCRS

Assistant Professor of Surgery
Rutgers Robert Wood Johnson Medical School
Atlantic Highlands, New Jersey, United States

Disclosure information not submitted.
BS

Brendan Scully, Md

Assistant professor
Rutgers Robert Wood Johnson
New Brunswick, New Jersey, United States

Disclosure information not submitted.

Senior Author(s)

NM

Nell Maloney Patel, MD

Professor of Surgery; Vice Chair of Education
Rutgers Robert Wood Johnson Medical School
Westfield, New Jersey, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Sophia Zigouras, DO, MS: This individual has no financial relationships with ineligible companies.

Purpose/Background: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a surgical treatment for ulcerative colitis and familial adenomatous polyposis that offers preservation of continence and avoidance of a permanent stoma. Traditionally, this complex procedure was approached with an open technique, but with advances in laparoscopic and robotic surgery, more of the operation is being performed in a minimally invasive fashion. Still, approaches described in the literature often include the exteriorization of the ileum via the ileostomy site or a similarly small abdominal incision to create an extracorporeal J-pouch. Our video demonstrates that a totally intracorporeal robotic technique can successfully be applied to perform a proctectomy with ileoanal J-pouch.

Methods/Interventions: Our patient is a 45-year-old female with medically refractory ulcerative colitis who previously underwent a laparoscopic subtotal colectomy with end ileostomy. We performed a robotic completion proctectomy and were able to create the ileal J-pouch and perform the ileoanal anastomosis in a totally intracorporeal fashion.

Results/Outcomes: Our video demonstrates the successful application of a totally intracorporeal technique to create an ileoanal J-pouch during robotic proctectomy with IPAA. The surgery and post-operative course were uneventful, the patient had no leak clinically or radiographically, and seven weeks later, the diverting loop ileostomy was successfully reversed. To date, the patient is doing well with no pouch complications.

Conclusion/Discussion: A robotic totally intracorporeal approach to ileoanal J-pouch creation is a safe and effective alternative to an extracorporeal approach and may minimize torsion and tension on the mesentery, especially in patients with an elevated BMI and thick abdominal wall.