This video shows the differences between handsewn and stapled ileo-anal anastomosis. In regard to the stapled anastomosis, the different ways of carrying out the purse string, with related advantages and risks, are shown. Also discussed are the results and the complications of the two techniques, in a series of 132 ileal pouch-anal anastomoses (62 stapled and 70 handsewn) carried out between 1985 and 1991.