title: Stages and evaluation of surgical innovation: a clinical example of the ileo neorectal anastomosis after ulcerative colitis and familial adenomatous polyposis.
abstract: OBJECTIVE
  So far, not many clinical examples that follow the IDEAL (Idea, Development, Evaluation, Assessment, and Long-term study) recommendations for evaluating and reporting surgical innovation and adoption are available.
  
  
  METHODS
  In this article, all IDEAL stages will be described for a recent surgical innovation, the ileo neorectal anastomosis (INRA), a procedure restoring intestinal continuity after colectomy.
  
  
  RESULTS
  INRA showed that the technique of small-bowel transposition with a vascular pedicle is feasible, with good long-term results. From the patient's point of view, no distinct advantage for INRA was found, with morbidity and functional results being in range with the gold standard ileal pouch anal anastomosis.
  
  
  CONCLUSIONS
  The adoption of the IDEAL recommendations-that is, by performing evidence-based surgical studies-will improve surgical science, with the consequence that progress in surgical care continues and interventions become safer and more efficient and allow a better quality of life in surgical patients.
authors.affiliation: 1Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
authors.forename: Joost T
authors.initials: JT
authors.lastname: Heikens
authors.forename: Hein G
authors.initials: HG
authors.lastname: Gooszen
authors.forename: Maroeska M
authors.initials: MM
authors.lastname: Rovers
authors.forename: Cees J H M
authors.initials: CJ
authors.lastname: van Laarhoven
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000193:education / Q000379:methods* / Q000592:standards / Q000639:trends; D003093:Colitis, Ulcerative / Q000601:surgery*; D003107:Colorectal Surgery / Q000193:education / Q000379:methods / Q000592:standards / Q000639:trends; D019317:Evidence-Based Medicine; D006801:Humans; D007082:Ileum / Q000601:surgery*; D012007:Rectum / Q000601:surgery*