What other pouch configurations can be surgically created besides a J-pouch for IPAA?

• A. S-pouch and W-pouch
• B. P-pouch and Q-pouch
• C. R-pouch and T-pouch
• D. U-pouch and V-pouch

Answer: (A)

In ileal pouch-anal anastomosis, the pouch is created from a segment of ileum to store stool and connect to the anus. While the J-pouch is the most common form, surgeons can craft alternative shapes to fit the pelvis or ileal length. The S-pouch uses a longer, serpentine ileal segment folded into an S shape to form a larger reservoir without placing excessive tension on the connection. The W-pouch expands on that idea by using three ileal limbs to create an even longer reservoir, which can further increase storage capacity. These are recognized alternatives when a standard J-pouch isn’t ideal due to anatomy or prior surgery. Other lettered configurations (not standardly used in practice) aren’t part of typical surgical options.