Laparoscopic total proctocolectomy and ileal pouch is a technically demanding procedure.

In this video, we perform a one-stage "pure" laparoscopic total proctcolectomy and ileal anal pouch anastomosis for a patient with chronic ulcerative colitis who is refractory to medical therapy. This video outlines steps of performing this difficult operation.

Laparoscopic total proctocolectomy was performed using medial to lateral approach, with the identification and division he operation highlights identification and preservation of vital structures prior to mesenteric divisions and laparoscopic rectal dissection.

This video details step by step approach to performing a laparoscopic total proctocolectomy for ulcerative colitis using the medial to lateral approach.