Ileoanal J-Pouch Prolapse: Successful Laparoscopic Pouchopexy with a Biological Mesh

Proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the standard surgical treatment for patients with intractable ulcerative colitis, undergoing elective resections. This procedure can be performed by an open or laparoscopic approach and is associated with a good quality of life and longterm outcomes [1]. However, there are several well-known complications of the procedure and the pouch itself. Common late complications include anastomotic strictures, residual proctitis/ pouchitis and poor pouch function [2]. Prolapse of the pouch on the other hand, is an uncommon complication, rarely described in the literature. Therefore the experience with management of the complication is very limited. The surgical treatments reported include transanal repair, transabdominal pouchopexy and transabdominal revision or removal [3,4]. A single case-report describes a successful robotic-assisted laparoscopic pouchopexy [5]. Only a few reports describe the repair of pouch prolapse with synthetic material, and there is no report describing the use of a biological mesh. Therefore we present our experience with a case of J-pouch prolapse repaired with a biologic mesh using a laparoscopic approach.