Technicalities of the J Pouch Surgery

Overview
      So, for a J pouch surgery, what they do is they remove your whole colon (colectomy) and in most cases your rectum (but they leave the muscles).  They then fashion the end of your small intestine into the shape of a J which brings the name J pouch:

http://www.uwhealth.org/surgery/ileal-pouch-types/10491

They then connect the bottom of the J pouch to the rectum.  However, after this amount of trauma, your pouch needs to heal.  That is where the ostomy (or to be technical, ileostomy) comes in play.  The surgeon cuts a whole in your stomach approximately near the marked area your ostomy nurse had drawn on.  They take take some of the small intestine and pull it out of the hole like a loop, hence the loop ileostomy.  They then cut half way through it so that the upper hole empties the waste and the lower hole leads to the j pouch.  It is sutured onto the outside of the skin and, viola, you have a stoma:
    
http://av-pc.cx.cc/t/?key=loop-ileostomy-takedown.html

The ostomy bag then goes over the ileostomy to contain the waste.  After at least 3 months, it is time for the Take Down.  This surgery is much easier than the first one.  It involves taking the loop ileostomy, cutting off the stoma (since the intestine would act like dead tissue if reinserted in the body), and sewn back together to let you operate with your new J pouch:
     
http://lalupe7.297m.com/loop-ileostomy-takedown.html

Incisions
      There are two different ways to perform the J pouch surgery.  One is an open surgery which is what I had. It is one large incision down your stomach:
    
http://www.cumc.columbia.edu/dept/cs/pat/colorectal/procedures.html

The other option is laparoscopic.  This procedure has several small incisions where the laparoscopic tools were inserted and a medium incision running horizontally far down your stomach (similar to a c-section).  This illustration is fairly close:
      
https://login.medscape.com/login/sso/getlogin?urlCache=aHR0cDovL3d3dy5tZWRzY2FwZS5jb20vdmlld2FydGljbGUvNzEwMjczXzI=&ac=401