Laparoscopic Abdominoperineal Pouch Excision (Video)

Step-by-step guidance from a Cleveland Clinic expert

Pouch excision may become necessary due to pelvic sepsis, poor function, dysplasia, malignancy and other indications.

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In this video, you’ll see highlights of a laparoscopic abdominoperineal pouch excision followed by the construction of an ileostomy.

Steven Wexner, MD, Director of the Digestive Disease Center and Chair of Colorectal Surgery at Cleveland Clinic Florida, explains the procedure step by step and offers guidance on:

  1. Proper port placement
  2. Why it’s important to mobilize the small bowel
  3. Pelvic dissection of the pouch
  4. Perineal intersphincteric dissection and transanal delivery of the pouch
  5. Closure of the perineum
  6. Construction of the stoma


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