@CSSunshine In the original post you wrote that your son has already had a colectomy. It’s not clear from your post how much of the rectum is still intact. You didn’t indicate what the underlying reason for the colectomy was, which would influence any decision about trying to preserve the rectum versus trying to remove most (or all) of it. In the most common (stapled) J-pouch technique a small (1-2 cm) rectal cuff is left behind as an attachment point for the J-pouch.