The role of the double-stapled technique and the ileoanal pouch

The technique of ileal reservoir with ileoanal anastomosis was first described in 1978 as an alternative to total proctocolectomy with permanent ileostomy for patients with mucosal ulcerative colitis and familial adenomatous polyposis. Since its inception, the operation has undergone several modifications. The use of stapling devices has greatly simplified pouch construction and has improved functional results. It has also obviated the need for rectal mucosectomy. Even though the ileoanal reservoir is well suited for a double-stapled technique with good long-term results, it is imperative that the surgeon be trained in other methods of pouch construction in case of technical failure of a mechanical stapler.