I'm 100% done with my jpouch and will be getting it removed soon.
This might be a question that only Jan is familiar with, but has anyone had surgery, specifically pouch removal using the TAMIS (transanal) platform? Can it lower the risk of pelvic nerve (sexual/urinary dysfunction) injury?
It is currently being performed in Florida and a few other places around the world.
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Actually, I don't know anything about this, so I had to look it it up. It appears that it is Trans Anal Minimally Invasive Surgery. It is for removing colorectal tumors. No where did I see any indication for its use for ileal pouch removal, which is about as invasive as you get.
https://www.floridahospital.co...vasive-surgery-tamis
The only trananal pouch procedure I am aware of is pouch advancement, where only the rectal cuff is removed, not the entire pouch.
I could be wrong. Did your doctor suggest this was an option for you?
Jan 
I spoke with the surgeon who does it in Orlando FL. He said he does these about 7-9 /y but hopes Tamis will see wider adoption soon.
Argument is that bottom up (transanally) you can visualize nerves better and also insufflate to further improve visualization and avoid nerves. I can see how that would be true. This is my #1 concern about excision. Still, there is very little published data. He claims ultra low nerve injury risk and even might not need a lap site other than stoma site of course.
Do you think the argument might hold water? CC surgeons say they think it adds no benefit for this, only useful for TME of low rectal cancer.
Are you saying he performs 7-9 pouch removals a year using TAMIS, or 7-9 TAMIS procedures total? Has he done ANY j-pouch removals this way, or does he assume it is possible?
I am asking because pouch removal is rather rare, and associated with a lot of adhesions.
Jan
7-9 Jpouch ops, I believe he meant 7-9 J pouch removals.
He has done it.
With a laparascopic approach (transanal or not) wouldn't the adhesions be somewhat less?
I'm hoping it won't become an issue for me in future, but I really feel strongly that my QoL with a jpouch is and will be much lower than with an ileostomy. I also don't want to carry a defunctioned jpouch for many decades.
Solomon, the issue with adhesions isn't about forming new ones, it's about doing the surgery without being able to see them, and cut them safely. The pouch can potentially have many adhesions to whatever is next to it.
Just reviving this thread with a summary article about using TAMIS for j-pouches with problems:
https://academic.oup.com/ecco-...ement_1/S066/5705619
It's from the Netherlands.
