If you wish to have only one surgery, you should consider the permanant stoma, or "end ileostomy" option:
Most often, patients will have a subtotal colectomy done in the first surgery. At this time an ileostomy will be performed. This provides you with the option to have a second, final surgery, and end with a stoma, or to undergo a J pouch reconstruction:
J pouch surgery will take place in multiple stages, for some patients 2 surgeries, but for most patients, 3 surgeries. If you are eligible and elect to proceed with a J pouch reconstruction, following a subtotal colectomy with a temporary end ileostomy, your surgeon will construct the J pouch in the next surgery; in most cases, a new stoma, or "loop ileostomy" aka "diverting ileostomy" will be created at this time. A 3rd, final surgery will reverse the loop ileostomy and the J pouch will then be in use:
Following a subtotal colectomy, it may be possible to construct the J pouch in the next surgery without the need for a diverting ileostomy:
In some cases, for instance, for cancer or pre-cancer concerns, your surgeon can remove your colon and most of your rectum and construct the J pouch in one procedure. At that time, an ileostomy will be performed and a temporary stoma created. There will then be one more surgery later time to reverse the temporary ileostomy:
