The purpose of this video is to present the technical aspects of laparoscopic colectomy and ileoanal pull-through and the surgical options based on anatomic differences in childhood. Laparoscopic total abdominal colectomy is possible for children despite high-dose corticosteroid administration and debilitation in patients with Ulcerative Colitis. The mesenteric root tends to be short, requiring intracorporeal division of blood vessels for adequate mobilization. Adjacent structures, in particular the duodenum, pancreas, and spleen can lie very close to the colon and require special consideration during the dissection. The use of hemostatic dissectors in addition to regular cautery improves dissection by reducing blood loss in children on high-dose steroids. The low lithotomy position is essential for unobstructed motion of the laparoscopic instruments. A 5mm or 10mm umbilical port is selected based on patient size. Three additional 5-10mm trocars are placed in line with the future suprapubic incision or at more lateral sites as indicated by initial exploration. Hand-assist laparoscopy is not necessary and may be difficult in small children. Omental preservation is possible and can be done at surgeon discretion. It is easiest to begin dissection at the hepatic flexure and then proceed to the splenic flexure prior to vessel division. Laparoscopic cecal and rectal mobilization is optional but not necessary if open construction of the pouch is planned. Transanal removal of the specimen occurs after mucosal proctectomy. A Pfannenstiel incision is adequate for open construction of the J-pouch and pelvic dissection as necessary. The varying lengths of the J-pouch in children and the relatively short mesentery may preclude total laparoscopic repair, but increased experience may make this possible.