The most common type of surgery for ulcerative colitis is a proctocolectomy. The surgeon removes both the colon and the rectum which together make up the large intestine. There are two types of these procedures. One is a proctocolectomy with ileal pouch-anal anastomosis (IPAA). This procedure involves the removal of the colon and rectum, and the creation of an internal pouch (shaped like a J) which removes the need to have a permanent external ostomy. This particular procedure is also known as J-pouch surgery. The other procedure is a proctocolectomy with end ileostomy, which involves removing the colon, rectum, and the anus and creating an external ostomy. The J-pouch surgery (IPAA) is the more commonly performed surgery in ulcerative colitis.