J-Pouch Surgery (IPAA) in Los Angeles

Restorative surgery for ulcerative colitis and FAP — removing the diseased colon while preserving natural bowel function, without a permanent ostomy.

Life After Colitis, Without a Permanent Bag

For patients with ulcerative colitis that no longer responds to medication — or with familial adenomatous polyposis (FAP) — removing the colon and rectum can be a cure. J-pouch surgery, formally called ileal pouch-anal anastomosis (IPAA), goes one step further: it rebuilds a functioning internal reservoir from your own small intestine, so you can have normal bowel movements without a permanent ostomy.

Dr. Moshe Barnajian is a fellowship-trained colorectal surgeon in Los Angeles who performs J-pouch surgery using minimally invasive and da Vinci® robotic techniques — smaller incisions, more precise pelvic dissection, and a faster, more comfortable recovery.

Who Is a Candidate for a J-Pouch?

Ulcerative colitis that is severe, refractory to medication, or steroid-dependent

Precancerous changes (dysplasia) or cancer found in the setting of colitis

Familial adenomatous polyposis (FAP) requiring removal of the colon and rectum

Patients who strongly wish to avoid a permanent ileostomy

Adequate sphincter muscle function (evaluated before surgery)

Crohn’s disease is generally NOT treated with a J-pouch — accurate diagnosis matters

How J-Pouch Surgery Works

IPAA is typically performed in planned stages for safety, most often two or three operations spaced weeks apart.

Stage 1: Colon Removal

The diseased colon (and usually rectum) is removed robotically through small incisions. A temporary ileostomy protects healing.

Stage 2: Pouch Creation

A "J"-shaped reservoir is constructed from the end of the small intestine and connected to the anal canal with precision — this is where surgical expertise directly affects lifelong function.

Stage 3: Ostomy Reversal

Once the pouch has healed, the temporary ileostomy is closed. Most patients settle into 4–8 soft bowel movements per day with good control.

Lifelong Pouch Care

Dr. Barnajian follows his pouch patients long-term, managing pouchitis and function so your result lasts a lifetime.

Dr. Moshe Barnajian, colorectal surgeon Los Angeles

Why Choose Dr. Barnajian?

Board-certified colorectal surgeon (FASCRS), trained at Cedars-Sinai, specializing in minimally invasive and da Vinci® robotic surgery. Compassionate, thorough care with most PPO insurance accepted.

Call (424) 622-9028

Frequently Asked Questions

Will I be cured of ulcerative colitis after J-pouch surgery?

Removing the colon and rectum removes the disease itself. Most patients stop colitis medications entirely and describe their quality of life as dramatically better.

How many bowel movements will I have with a J-pouch?

After a settling-in period, most patients average four to eight soft bowel movements a day with good control, including through the night for the majority.

Is J-pouch surgery done robotically?

Yes. Dr. Barnajian performs IPAA with minimally invasive and da Vinci® robotic techniques, which allow exceptionally precise work deep in the pelvis and quicker recovery than open surgery.

How long is recovery between stages?

Typically two to three months between operations, with most patients back to normal activity within a few weeks after each stage. The full journey usually spans six to nine months.