After procotolectomy for ulcerative colitis or FAP, creation of a continent ileostomy is one of the surgical options. Although most patients will be offered a pull-through procedure, the continent ileostomy is a valuable alternative in patients who are either not candidates for or have failed an ileal pouch-anal anastomosis or who for other reasons prefer a permanent ileostomy. Traditional continent reservoirs (Kock or Barnett pouch) with an intussuscepted bowel segment as valve mechanism have an unsatisfactorily high incidence of dysfunction and frequent reoperations. Urologist who adopted the Kock pouch for continent urinary diversion encountered similar problems as well as ischemic valve structuring and formation of stones around exposed stapler materials. In an effort to prevent the problems of nipple dislodgement and pouch leakage, a new type of pouch was developed for urinary diversion in 1998. Because the concept of this new T-pouch does not reply on an intussusceptive valve, the valve cannot come apart. In this video presentation we have adapted the T-pouch valve concept for a continent stool reservoir which omits the intussuscepted valve and maintains the blood supply to the valve segment. To date we have preformed this new T-pouch on over 20 patients with excellent function results and high patient satisfaction.