Digestive Care Innovations Hub

Non-invasive/Minimally Invasive Procedures

Pouch Surgery to Help People with Ulcerative Colitis

People with ulcerative colitis, many of whom are young adults in the prime of their lives, may suffer from debilitating symptoms that can rob them of their comfort, independence, and well-being. They may also fear needing a colectomy and ileostomy — removal of the colon with a bag worn outside the abdomen to collect waste (ostomy). At NewYork-Presbyterian/Columbia University Irving Medical Center, our surgeons are experts in innovative procedures for people with ulcerative colitis whose symptoms cannot be well-controlled with medication or those with colitis-associated cancerous or precancerous conditions, needing surgery. These include J-pouch and K-pouch surgery, where an internal pouch is created as a reservoir for stool. With the J-pouch, patients can empty waste normally via the rectum. With the K-pouch surgery, patients whose only other option would have been an ostomy, can have a pouch created inside the abdomen that is emptied externally through a tube hence avoiding an external bag.

Our team has extensive experience with the planning and creation of these pouches and revision surgeries for pouch-related problems, such as "pouchitis" — inflammation of the pouch, Crohn’s disease of the pouch, pouch strictures, pouch abscesses, and pouch fistulae. People who were not able to undergo this surgery elsewhere had their lives restored at NewYork-Presbyterian/Columbia. Our medical, endoscopic, and surgical pouch specialists are often able to preserve intestinal function in even the most complex cases. Our Center for Ileal Pouch Disorders and Center for Corrective Endoscopy/Surgery in Inflammatory Bowel and Colorectal Diseases has provided the state-of-the-art care of patients from New York, the US, and abroad.

Reasons to consider pouch surgery

  • Live without the pain, frequent bowel movements, and other symptoms of ulcerative colitis
  • Maintain more independence
  • Live without an ileostomy
  • Improve your quality of life and well-being
  • Minimally invasive endoscopic procedures performed in an outpatient setting
  • Minimally invasive surgical procedures performed through small abdominal incisions and associated with a faster recovery

How does pouch surgery work?

  • To create the J-pouch, the surgeon removes the diseased colon and rectum and attaches the lower part of the small intestine (the ileum) to the top of the anus, creating a J-shaped pouch where stool collects. You would pass stool normally, with no need to wear a colostomy bag.
  • To create the K-pouch, the surgeon creates an internal pouch which has an opening to the outside of the abdomen. You would empty stool from the pouch through a catheter and dispose of it. There is no external colostomy bag.
  • Various minimally invasive, outpatient endoscopic procedures are offered to treat a wide spectrum of pouch disorders, ranging from pouch strictures to pouch fistula and abscess.
  • Revision surgery is an operation to correct a problem with a previously constructed pouch and is tailored to your needs. We have cared for many patients who received unsuccessful procedures from other hospitals. Our surgeons have exceptional experience with revision surgery to help you regain bowel comfort and control.

Is pouch surgery for me?

The first line of treatment for ulcerative colitis is medication, but sometimes symptoms become so severe that drugs are not enough and surgery is needed. If you have ulcerative colitis that requires surgery, you may benefit from one of these procedures and live with a better quality of life.

Learn about one patient's experience with K-pouch surgery for ulcerative colitis.