Pouch removal and anal closure surgery is a very complicated very big surgery. Supposedly it is far more complicated than colon removal or jpouch creation surgery. I would definitely only have an extremely experienced surgeon do this, one that has done it many times before. In addition, this surgery is at high risk for complications. So you want to be sure your surgeon and hospital is prepared to handle any potential complications. I can attest to this as I had my full pouch removal surgery done by the top surgeon at the best of the best facilities (Cleveland Clinic) and I still suffered with many extensive and significant complications. I couldn't imagine having had it done by anyone else or at any other facility that wouldn't have been prepared to handle it Also as you state.. you have to be prepared time wise for this. Nearly 3 months after the surgery, I am still out of commission.