Topic Explanation:
The discussion revolves around preparing for an ileostomy surgery, specifically a permanent ileostomy, total colectomy, and Hartman pouch to close the rectum. The original poster is seeking advice on important questions to ask the surgeon prior to the procedure. Key concerns raised include the rationale behind retaining the rectum and the optimal length and placement of the stoma.

Extracted Advice and Helpful Insights:
1. Surgical Technique and Surgeon's Experience:
- Inquire if the surgery will be performed laparoscopically and if not, understand why.
- Check the surgeon's experience specifically with ileostomy and related procedures.

2. Rectum Retention:
- Discuss the reasons for retaining the rectum and potential long-term implications, such as the risk of cancer or the need for ongoing proctoscopies.
- Consider the benefits of removing the rectum to avoid future complications like mucus drip or additional surgeries.

3. Stoma Considerations:
- Discuss the length and protrusion of the stoma, as it affects the ease of attaching ostomy appliances and managing output.
- Ensure the stoma site is planned away from skin folds to prevent leaks and skin irritation.
- Some suggest a stoma that protrudes 1” to 1.5” above the skin to facilitate easier management and prevent skin issues.

4. Closure Techniques Post-Surgery:
- If opting for closure of the anus (often referred to as "Barbie butt" or "Ken butt"), clarify whether the buttocks will also be sewn together, as this can impact healing and personal comfort.
- Understand the healing process and potential complications from closing the anus, as recovery can vary widely among individuals.

5. Post-Surgical Expectations and Lifestyle Adjustments:
- Prepare for lifestyle adjustments such as managing a stoma and potential changes in bodily functions.
- Discuss potential nerve damage risks, especially if previous surgeries in related areas have occurred.

6. Additional Surgical Insights:
- Some surgeons may leave the rectum intact for potential future reversals or due to existing complications.
- Understand any additional procedures that might be recommended, like sigmoidoscopies, to monitor the retained rectum.

7. Personal Experiences and Preferences:
- Consider sharing and discussing personal preferences and concerns with the surgeon, especially regarding sexual function and quality of life post