ABSTRACT

Ileal pouches originated from the researches of Kock who, in the 1960s, developed the continent ileostomy, followed in the 1970s by the ileoanal procedure of Parks. Both operations revolutionized the surgical management of ulcerative colitis, and, to a lesser extent, familial adenomatous polyposis and certain functional disorders, for example, megarectum. The indications for pouch procedures have centered around the pathological appearance of the disease in question. Essentially, pouch procedures have been applied to disorders that affect the large bowel and the mucosa in particular, allowing a complete removal of the large bowel mucosa through a combination of conventional excision of the colon and rectum with a mucosectomy in the distal anorectal stump.