Restorative proctocolectomy

Restorative proctocolectomy (RP) or 'pouch' procedure is arguably the gold standard operation in the surgical management of ulcerative colitis (UC). I t is also indicated in selected cases of familial polyposis coli (FPC) and constipation. Since the initial description by Parks and Nicholls in 1978 t he operation has undergone many modifications.(1) Surgeons have adopted a v ariety of techniques based on their own experience, their understanding of the pathology and individual surgical abilities. This difficult operation c alls for not just one technique, but requires versatility to manage problem s as they arise. The authors present their surgical preferences and the rat ionale behind choosing certain procedures.