Pouch Surgery in the 21st Century: Evolving Techniques and Considerations

An ileoanal pouch with ileal pouch-anal anastomosis is the preferred method for restoring intestinal continuity after total proctocolectomy. Changes in medical management and technological advancements have improved pouch surgery. The number of stages, minimally invasive approaches, pouch design, and anastomotic configuration are key considerations. The laparoscopic j pouch with double-stapled anastomosis is the current standard, but individualized approaches are essential for success.