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Vascular dissection and division plays a very important role in pouch formation. Not only it influences the size of the pouch, as the vascularization and failure rate. The division of the ileocolic vessels is still contradictory, with some studies revealing clear benefits, while others relating it with pouch failure. In this 10th episode of the Ileal Pouch Series, Dr. Peter Kienle MD PhD shares the different views and his personnel experience on the matter.