It depends on whether he has Crohn's or not. If his problem was not Crohn's they may be able to either connect his small bowel to his rectum or, if his rectum is diseased, create a new rectum out of his small bowel and sew it into his rectal muscles (J-Pouch surgery). With Crohn's they won't do the J-Pouch as the disease may reoccur in the small bowel and you can't afford to lose any of it to the J-Pouch surgery.
Hi - I underwent a total colectomy nearly five years ago - but for torrential diverticular bleeding. Another name for the procedure was an ileorectal anastomosis whereby the farthest end of the ileum is connected to the top of the rectum. I did not require any pouches/stoma attachments etc.
In response to another Medhelp patient I described my experience on Medhelp - please log on to:-
Hope this helps.