Reoperative transabdominal surgery for ileoanal pouch salvage

Restorative proctocolectomy with ileal pouch-anal anastomosis (RP/IPAA) is performed for surgical management of ulcerative colitis (UC) familial adenomatous polyposis (FAP), indeterminate colitis, and an extremely selected subset of patients with Crohn׳s disease (CD). Around one-tenth of ileoanal pouches fail in long term due to septic, mechanic, functional, or biologic complications. Transanal, transabdominal, or combined approaches are safe and feasible to salvage ileoanal pouch. This article focuses on reoperative transabdominal surgery for ileoanal pouch salvage. Transabdominal redo IPAA surgery is technically complex and a patient-driven procedure. The success of transabdominal redo IPAA surgery is highly correlated with patient׳s motivation, physician's experience, institutional infrastructure, and caseload.