This topic is about someone sharing their positive experience after undergoing a specific type of surgery called a single-incision laparoscopic proctectomy with sphincter preservation. This person is three weeks into their recovery and is feeling great. Here's a bit more about their journey and some helpful advice they offer:

- They had a total colectomy with an end-ileostomy back in December 2009 due to ulcerative colitis.
- In November 2012, they had their rectum removed laparoscopically, but their sphincter was left intact.
- The surgery involved a small horizontal incision along the pubic line, an incision at the belly button, and a tiny site for a drain.
- They had general anesthesia along with an epidural for pain control, which made waking up pain-free, unlike their previous surgery experience.
- Recovery has been smooth with minimal perineal pain, no need for special cushions, and they were able to walk their dog for 20 minutes and drive by the third week.
- They are thrilled with the quality-of-life improvements: no more pads or rectal discharge, no risk of rectal cancer, and finally being pain-free after 40 years.
- A follow-up with the surgeon is scheduled to discuss the surgical details.

Additional insights and advice include:

1. It's important to define what "success" means to you with your surgeon before the procedure, focusing on pain, continence, cancer risk, and quality-of-life goals.
2. Finding a colorectal specialist is crucial, as general surgeons might not have the necessary experience or may be pessimistic about the outcomes.
3. The term "Barbie Butt" refers to having cosmetically normal buttocks that no longer function, and the same concept applies to "Ken Butt" for men.
4. Sphincter removal isn't automatic with an ileostomy or proctectomy; it depends on various factors like disease, cancer, pelvic-floor considerations, and the surgeon's skill.
5. Sometimes, the rectum is kept during the first surgery to allow for a future J-pouch or to shorten the operation if the patient is unstable.
6. The procedure they underwent is called Single-Incision Laparoscopic Proctectomy – Sphincter Sparing.
7. They occasionally feel phantom "twinges" but have no pain, discharge, or pressure.

Some additional advice:

- Consider the benefits of preserving the sphincter and pelvic floor, especially for women, as it helps maintain anatomical support and may prevent future pelvic-floor issues.
- Understand that complete removal of the rectum and anus with permanent closure can work well for some, but individual experiences vary based on disease and healing factors.
- Chronic perineal wound issues are more common in Crohn’s patients due to aggressive disease affecting healing.
- The use of pads can be emotionally and financially taxing, and a successful proctectomy can eliminate this need for many.
- Epidural analgesia during and after surgery can significantly improve comfort compared to using IV opioids alone.