PRESENT EXPERIENCE WITH THE INDIANA POUCH

The Indiana pouch was developed as a modification of the Glichrist pro cedure in 1984. The need for full detubularization of the reservoir wa s recognized early and was achieved by an ileal patch on the cecal res ervoir or by an antimesenteric incision of the cecal segment with fold ing and transverse closure. the efferent limb and continence mechanism were modified to promote ease of catheterization and improved contine nce. These modifications gave markedly better results with lower reope ration rates. A group of 81 patients with a minimum of 2 years of foll ow-up are reported herein. The most recent modification uses absorbabl e GLA and TA55 staples to detubularize and close the reservoir. This s tapling technique has been employed in 20 patients and has resulted in decreased operating times without any significant increase in complic ations. In its current form, the Indiana pouch meets all the criteria for a satisfactory continent cutaneous reservoir and has a favorable r eoperation rate as compared with other pouches.