Her answer was none. Or more realistically, as little as possible, which was less than one centimeter. The reason? To avoid UC of the cuff, a.k.a. "cuffitis." She pointed on a diagram to where the cut had taken place, and it was pretty much right at my anus. She told me that leaving the rectal cuff in tact is almost never done anymore, which negates the need for the "scraping" or "mucosectomy" that people on various forums keep asking about.
I referenced a study from 1992 (twenty years ago) that discusses the necessity of the rectal cuff to continence. She said that strategies have come a long way since then, and in recent years in particular the newer stapling techniques have made a big improvement in the way they go about constructing and attaching J-pouches, and that is likely what has made the difference.
Either way, I can't believe that she would be so revered/respected if she was making a practice of leaving her patients incontinent, so I trust this surgeon, and she says that the rectal cuff is no longer necessary for continence. I will let you all know how continent I am after takedown.
