Nowadays most Authors agree that preserving the rectum is useless, so it is sectioned at the level of anorectal junction. The preparation of the rectum toward anorectal junction is usually intramesorectal, which rises the risk of bleeding but also reduces the risk of nerve lesions. However mesorectal excision is mandatory in case of either severe dysplasia or cancer. After pouch construction, ileopouch-anal anastomosis can be either manual or stapled. When mucosectomy is performed, it is necessary to fashion manual ileoanal anastomosis intra-anally by suturing the pouch to the anus with some stiches between it and the linea dentata
