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Surgery can be a permanent treatment for ulcerative colitis. The correct surgical procedure is a total proctocolectomy and
ileo anal J pouch anastomosis (IPAA). This procedure is feasible also in laparoscopic approach after a correct learning
curve. Pouchitis, pouch complications, intestinal occlusion, infertility are the most common long term complications. We
present a case of a 37 year old man treated with laparoscopic proctocolectomy and followed at 18 months.