Analysis of Differences in Electrochemical Performance Between Coin and Pouch Cells for Lithium-Ion Battery Applications

Small coin cell batteries are predominantly used for testing lithium-ion batteries(LIBs)in academia because they require small amounts of material and are easy to assemble.However,insufficient attention is given to difference in cell performance that arises from the differences in format between coin cells used by academic researchers and pouch or cylindrical cells which are used in industry.In this article,we compare coin cells and pouch cells of different size with exactly the same electrode materials,electrolyte,and electrochemical conditions.We show the battery impedance changes substantially depending on the cell format using techniques including Electrochemical Impedance Spectroscopy(EIS)and Galvanostatic Intermittent Titration Technique(GITT).Using full cell NCA-graphite LIBs,we demonstrate that this difference in impedance has important knock-on effects on the battery rate performance due to ohmic polarization and the battery life time due to Li metal plating on the anode.We hope this work will help researchers getting a better idea of how small coin cell formats impact the cell performance and help predicting improvements that can be achieved by implementing larger cell formats.

Complications after ileal pouch-anal anastomosis in Korean patients with ulcerative colitis

AIM: To investigate the outcomes of treatments for complications after ileal pouch-anal anastomosis (IPAA) in Korean patients with ulcerative colitis.

Relationship between pouch microbiota and pouchitis following restorative proctocolectomy for ulcerative colitis

Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP).UC patients with IPAA(UC-IPAA)are,nevertheless,susceptible to inflammatory and noninflammatory sequelae such as pouchitis,which is only rarely noted in FAP patients with IPAA.Pouchitis is the most frequent long-term complication of UC-IPAA patients,with a cumulative prevalence of up to 50%.Although the aetiology of pouchitis remains unclear,accumulating evidence suggests that a dysbiosis of the pouch microbiota and an abnormal mucosal immune response are implicated in its pathogenesis.Studies using culture and molecular techniques have detected a dysbiosis of the pouch microbiota in patients with pouchitis.Risk factors,genetic associations,and serological markers suggest that interactions between the host immune response and the pouch microbiota underlie the aetiology of this idiopathic inflammatory condition.This systematic review focuses on the dysbiosis of the microbiota that inhabit the pouch in UC and FAP patients and its interaction with the mucosal immune system.A metaanalysis was not attempted due to the highly heterogeneous microbiota composition and the different detection methods used by the various studies.Although no specific bacterial species,genus,or family has as yet been identified as pathogenic,there is evidence that a dysbiosis characterized by decreased gut microbiota diversity in UC-IPAA patients may,in genetically predisposed subjects,lead to aberrant mucosal immune regulation triggering an inflammatory process.

Risk of ileal pouch neoplasms in patients with familial adenomatous polyposis

Restorative proctocolectomy is the most common surgical option for patients with familial adenomatous polyposis(FAP). However,adenomas may develop in the ileal pouch mucosa over time,and even carcinoma in the pouch has been reported. We therefore reviewed the prevalence,nature,and treatment of adenomas and carcinoma that develop after proctocolectomy in the ileal pouch mucosa in patients with FAP. In 25 reports that were reviewed,the incidence of adenomas in the ileal pouch varied from 6.7% to 73.9%. Several potential factors that favor the development of pouch polyposis have been investigated,but many remain controversial. Nevertheless,it seems certain that the age of the pouch is important. The risk appears to be 7%to 16% after 5 years,35% to 42% after 10 years,and75% after 15 years. On the other hand,only 21 cases of ileal pouch carcinoma have been recorded in the literature to date. The diagnosis of pouch carcinoma was made between 3 to 20 years(median,10 years) after pouch construction. Although the risk of malignant transformation in ileal pouches is probably low,it is not negligible,and the long-term risk cannot presently be well quantified. Regular endoscopic surveillance,especially using chromoendoscopy,is recommended.

Ileal pouch surgery for ulcerative colitis

Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum. Treatment may vary depending upon the extent and severity of inflammation. Broadly speaking medical treatments aim to induce and then maintain remission. Surgery is indicated for inflammatory disease that is refractory to medical treatment or in cases of neoplastic transformation. Approximately 25% of patients with UC ultimately require colectomy. Ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis who ultimately require colectomy. This review will examine indications for IPAA, patient selection, technical aspects of surgery, management of complications and long term outcome following this procedure.

Successful treatment of severe pouchitis with rebamipide refractory to antibiotics and corticosteroids:A case report

The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report, we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide, known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea, and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema （3.95 rag/dose）. However, despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema （150 rag/close） twice a clay for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4^th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation. The effect of rebamipide enema was dramatic and was maintained throughout the ll-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period. The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions.

Modified Indiana Pouch Following Radical Cystectomy

Objective To investigate the indications, operation techniques and clinical effects of a modified technique of Indiana pouch. Methods A modified technique of Indiana pouch was performed on 5 patients following radical cystectomy. Results 5 cases showed satisfactory therapeutic effects with of follow-up range of 6 to 30 months. All patients were continent day and night with easy catherization. The number of micturations was 5 to 6 times in the daytime and 1 to 3 times in the nighttime. Cystography of 4 cases showed that pouches were spheroidic and volumes were between 400 to 500 ml. Conclusion The advantages of the modified Indiana pouch are as follows: easy manipulation; low tension and high volume in pouches; no reflux; satisfactory urinary continence and few complications. Therefore, it is worthy of clinical popularization.

Infliximab for the treatment of pouchitis

Pouchitis is not a rare complication that develops after an ileal-pouch anastomosis, performed after colectomy in patients refractory to treatment or with complicated ulcerative colitis. This condition may become chronic and unresponsive to medical therapies, including corticosteroids, antibiotics and probiotics. The advent of biological therapies(tumor necrosis factor-α inhibitors) has changed the course of these complications. In particular, in these cases, infliximab(IFX) may represent a safe and effective therapy in order to avoid the subsequent operation for a permanent ileostomy. This article reviews the therapeutic effects of one of the most widely used anti-tumor necrosis factor-α molecules, IFX, for the treatment of complicated pouchitis(refractory to conventional treatment and/or fistulizing).

Diet of patients after pouch surgery may affect pouch inflammation

AIM:To investigate the diet of pouch patients compared to healthy controls,and to correlate pouch patients’diet with disease behavior.METHODS:Pouch patients were recruited and prospectively followed-up at the Comprehensive Pouch Clinic at the Tel Aviv Sourasky Medical Center.Pouch behavior was determined based on clinical,endoscopic and histological criteria.Healthy age-and sex-matched volunteers were selected from the"MABAT"Israeli Nutrition and Public Health Governmental Study and served as the control group.All the participants completed a 106-item food frequency questionnaire categorized into food groups and nutritional values based on those used in the United States Department of Agriculture food pyramid and the Israeli food pyramid.Data on Dietary behavior,food avoidance,the use of nutritional supplements,physical activity,smoking habits,and body-mass index(BMI)were also obtained.Pouch patients who had familial adenomatous polyposis(n=3),irritable pouch syndrome(n=4),or patients whose pouch surgery took place less than one year previously(n=5)were excluded from analysis.RESULTS:The pouch patients(n=80)consumed significantly more from the bakery products food group(1.2±1.4 servings/d vs 0.6±1.1 servings/d,P<0.05)and as twice as many servings from the oils and fats(4.8±3.4 servings/d vs 2.4±2 servings/d,P<0.05),and the nuts and seeds food group(0.3±0.6 servings/d vs 0.1±0.4 servings/d,P<0.05)compared to the controls(n=80).The pouch patients consumed significantly more total fat(97.6±40.5 g/d vs 84.4±39 g/d,P<0.05)and fat components[monounsaturated fatty acids(38.4±16.4 g/d vs 30±14 g/d,P<0.001),and saturated fatty acids(30±15.5 g/d vs 28±14.1 g/d,P<0.00)]than the controls.In contrast,the pouch patients consumed significantly fewer carbohydrates(305.5±141.4 g/d vs 369±215.2 g/d,P=0.03),sugars(124±76.2 g/d vs 157.5±90.4 g/d,P=0.01),theobromine(77.8±100 mg/d vs 236.6±244.5 mg/d,P<0.00),retinol(474.4±337.1μg/d vs 832.4±609.6μg/d,P<0.001)and dietary fibers(26.2±15.4 g/d vs 30.7±14 g/d,P=0.05)than the controls.Comparisons of the food consumption of the patients without(n=23)and with pouchitis(n=45)showed that the former consumed twice as many fruit servings as the latter(3.6±4.1 servings/d vs 1.8±1.7 servings/d,respectively,P<0.05).In addition,the pouchitis patients consumed significantly fewer liposoluble antioxidants,such as cryptoxanthin(399±485μg/d vs 890.1±1296.8μg/d,P<0.05)and lycopene(6533.1±6065.7μg/d vs 10725.7±10065.9μg/d,P<0.05),and less vitamin A(893.3±516μg/d vs1237.5±728μg/d,P<0.05)and vitamin C(153.3±130 mg/d vs 285.3±326.3 mg/d,P<0.05)than the patients without pouchitis.The mean BMI of the pouchitis patients was significantly lower than the BMI of the patients with a normal pouch:22.6±3.2 vs 27±4.9(P<0.001).CONCLUSION:Decreased consumption of antioxidants by patients with pouchitis may expose them to the effects of inflammatory and oxidative stress and contribute to the development of pouchitis.

Lactobacillus acidophilus alleviates pouchitis after ileal pouch-anal anastomosis in rats

AIM To assess the therapeutic potential of Lactobacillus acidophilus(LA) for the treatment of pouchitis in a rat model.METHODS Sprague Dawley rats underwent proctocolectomy and ileal pouch-anal anastomosis followed by administration of dextran sulfate sodium(DSS) to induce pouchitis. Rats with pouchitis were randomly divided into three groups: no intervention(NI), normal saline(NS, 3 m L/d normal saline for 7 d), and LA(3 m L/d LA at 1× 1010 colony-forming units for 7 d). General body condition was recorded and pouch specimens were obtained for histological examination. m RNA expression levels of interleukin(IL)-1β, IL-6, IL-10, and tumor necrosis factor-α were determined by RT-PCR. Zonula occludens protein 1(ZO-1) levels were measured by immunohistochemistry. RESULTS LA reduced weight loss associated with pouchitis(P < 0.05) and improved the symptoms of pouchitis in rats. Compared with the NI and NS groups, rats in the LAgroup showed earlier disappearance of hematochezia(6.17 ± 0.75, 6.50 ± 0.55, 3.17 ± 0.75, P < 0.05) and higher fecal scores(2.67 ± 0.48, 2.50 ± 0.51, 4.42 ± 0.50, respectively, P < 0.05). Histological scores were also lower in the LA group compared with the other two groups(7.17 ± 0.98, 8.00 ± 0.89, 4.00 ± 0.89, respectively, P < 0.05). m RNA expression levels of IL-1β, IL-6, and tumor necrosis factor-α were significantly reduced, while IL-10 m RNA levels were significantly increased in the LA group(P < 0.05, respectively). ZO-1 protein levels were also significantly increased after administration of LA(P < 0.05). CONCLUSION LA alleviates pouchitis induced by DSS after ileal pouchanal anastomosis by decreasing pro-inflammatory factors and increasing anti-inflammatory factors, and restoring ZO-1 expression in the mucosa.

The pathogenesis of primary pouchitis following ileal pouch-anal anastomosis: a review of current hypotheses

Primary pouchitis is a common complication of ileal pouch-anal anastomosis following proctocolectomy in patients treated for ulcerative colitis (UC), but is un-usual for those treated for familial adenomatous polyposis (FAP). While a number of theories as to the pathogenesis of this inflammatory condition have been proposed, no single one has been wholly satis-factory. Much research has been devoted to investi-gating a link between the pathogenic factors involved in UC, but not FAP, and those underlying pouchitis. The contribution of sulfate-producing bacteria has also been explored. The role of other intraluminal factors, such as short chain fatty acids and unconju-gated bile salts, has also been investigated. A unifying theory of a multi-step process might explain the pathogenesis of pouchitis, but further research is re-quired to proof causation. It is likely that pouchitis develops as a result of a combination of genetic, im-munological, microbial and metabolic factors. Future insight into the causes of pouchitis may eventually allow for the development of more effective treat-ments.

Reversible and irreversible heat generation of NCA/Si–C pouch cell during electrochemical energy-storage process

To meet the requirements of electronic vehicles(EVs) and hybrid electric vehicles(HEVs),the high energy density Li Ni_(0.8) Co_(0.15) Al_(0.05) O_2(NCA) cathode and Si–C anode have attracted more attention.Here we report the thermal behaviors of NCA/Si–C pouch cell during the charge/discharge processes at different current densities.The total heat generations are derived from the surface temperature change during electrochemical Li+insertion/extraction in adiabatic surrounding.The reversible heat is determined by the entropic coefficients,which are related with open-circuit voltage at different temperatures; while the irreversible heat is determined by the internal resistance,which can be obtained via V–I characteristic,electrochemical impedance spectroscopy and hybrid pulse power characterization(HPPC).During the electrochemical process,the reversible heat contributes less than 10% to total heat generation; and the heat generated in charge process is less than that in discharge process.The results of thermal behaviors analyses are conducive to understanding the safety management and paving the way for building a reliable thermal model of high energy density lithium ion battery.

Ileal-anal pouches: A review of its history, indications, and complications

The ileal pouch anal anastomosis(IPAA)has revolutionised the surgical management of ulcerative colitis(UC)and familial adenomatous polyposis(FAP).Despite refinement in surgical technique(s)and patient selection,IPAA can be associated with significant morbidity.As the IPAA celebrated its 40th anniversary in 2018,this review provides a timely outline of its history,indications,and complications.IPAA has undergone significant modification since 1978.For both UC and FAP,IPAA surgery aims to definitively cure disease and prevent malignant degeneration,while providing adequate continence and avoiding a permanent stoma.The majority of patients experience long-term success,but“early”and“late”complications are recognised.Pelvic sepsis is a common early complication with far-reaching consequences of long-term pouch dysfunction,but prompt intervention(either radiological or surgical)reduces the risk of pouch failure.Even in the absence of sepsis,pouch dysfunction is a longterm complication that may have a myriad of causes.Pouchitis is a common cause that remains incompletely understood and difficult to manage at times.10%of patients succumb to the diagnosis of pouch failure,which is traditionally associated with the need for pouch excision.This review provides a timely outline of the history,indications,and complications associated with IPAA.Patient selection remains key,and contraindications exist for this surgery.A structured management plan is vital to the successful management of complications following pouch surgery.

Role of the Chinese Herbal Medicine Xianhuayin on the Reversal of Premalignant Mucosal Lesions in the Golden Hamster Buccal Pouch

Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Methodology The animals were randomly divided into a non-diseased control group （n=5） and an experimental group including 50 animals in which the buccal mucosa had been painted with DMBA （0.5% in acetone） to generate an oral mucosa premalignant lesion. Animals in the experi- mental group were further divided into Xianhuayin-treated group （n=30）, untreated prem＇alignant lesion group （n=10） and normal saline （NS）-treated group （n=10）. The cheek （buccal） pouch mucosa of the golden hamsters in each group was observed with light and electron microscopy eight weeks after intragastric administration with NS or Xianhuayin. Results In the non-diseased control group, the buccal mucosa was keratinized and stratified squamous epithelium under a light microscope. In the untreated premalignant lesion group, variable degrees of epithelial dysplasia was observed. The irregular epithelial mucosa gradually became distinct in the Xianhuayin-treated group. Scanning electronic microscopic （SEM） analysis showed that surface of the cells exhibited honeycomb structures in the hamster of untreated- group. The cells were morphologically irregular, overlapped and loosened in the untreated premalignant lesion group. Most of the cell surface exhibited honeycomb structure in the Xianhuayin-treated group. Transmission electronic micro- scopic （TEM） analysis showed that buccal mucosal epithelial cells were morphologically regular in the non-diseased control group. Desmosomes and tonofibrils were reduced and the nucleus was morphologically irregular in the untreated premalignant lesion group. In the Xianhuayin-treated group, the widening intercellular gap was gradually reduced, desmosomes and the cells becoming morphologically regular. No significant difference was observed between the hamsters in NS-treated group and those in the untreated premalignant lesion group. Significant therapeutic efficacy was observed in the group receiving Xianhuayin. Conclusion Xianhuayin is effective in the reversal of DMBA-induced premalignant lesions in the buccal pouch of golden hamsters.

Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis:A narrative review

Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still remain controversial,such as the approach(open or laparoscopic),number of stages in the surgery,type of pouch,and construction type(hand-sewn or stapled ileal pouch-anal anastomosis).The present narrative review aims to discuss current evidence on the short-,mid-,and long-term results of each of these technical alternatives as well as their benefits and disadvantages.A review of the MEDLINE,EMBASE,and Ovid databases was performed to identify studies published through March 2016.Few large,randomized,controlled studies have been conducted,which limits the conclusions that can be drawn regarding controversial issues.The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases.Regarding 2- and 3-stage RP-IPAA,patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables,making any comparisons extremely difficult.The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly,although the J pouch is generally preferred by surgeons.Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages,and there is no clear benefit of one technique over the other.

Rational design of MoS_(2) nanosheets decorated on mesoporous hollow carbon spheres as a dual-functional accelerator in sulfur cathode for advanced pouch-type Li–S batteries

Developing sulfur cathodes with high catalytic activity on accelerating the sluggish redox kinetics of lithium polysulfides(Li PSs) and unveiling their mechanisms are pivotal for advanced lithium–sulfur(Li–S)batteries. Herein, MoS2 is verified to reduce the Gibbs free energy for rate-limiting step of sulfur reduction and the dissociation energy of lithium sulfide(Li2 S) for the first time employing theoretical calculations. The Mo S2 nanosheets coated on mesoporous hollow carbon spheres(MHCS) are then reasonably designed as a sulfur host for high-capacity and long-life Li–S battery, in which MHCS can guarantee the high sulfur loading and fast electron/ion transfer. It is revealed that the shuttle effect is efficiently inhibited because of the boosted conversion of Li PSs. As a result, the coin cell based on the MHCS@Mo S2-S cathode exhibits stable cycling performance maintaining 735.7 mAh g^(-1) after 500 cycles at 1.0 C. More importantly, the pouch cell employing the MHCS@Mo S2-S cathodes achieves high specific capacity of1353.2 m Ah g^(-1) and prominent cycle stability that remaining 960.0 m Ah g^(-1) with extraordinary capacity retention of 79.8% at 0.1 C after 170 cycles. Therefore, this work paves a new avenue for developing practical high specific energy and long-life pouch-type Li–S batteries.

Pouchitis

While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery,complications can occur.Pouchitis as the most common long-term complication represents a spectrum of disease processes ranging from acute,antibiotic-responsive type to chronic antibiotic-refractory entity.Accurate diagnosis using a combined assessment of symptoms,endoscopy and histology and the stratification of clinical phenotypes is important for treatment and prognosis the disease.The majority of patients respond favorably to antibiotic therapy.However,management of chronic antibiotic-refractory pouchitis remains a challenge.

Constructing a 700 Wh kg^(-1)-level rechargeable lithium-sulfur pouch cell

Lithium–sulfur(Li–S)batteries are considered as highly promising energy storage devices because of their ultrahigh theoretical energy density of 2600 Wh kg^(-1).The highest practical energy density of Li–S batteries reported at pouch cell level has exceeded 500 Wh kg^(-1),which significantly surpasses that of lithium-ion batteries.Herein,a 700 Wh kg^(-1)-level Li–S pouch cell is successfully constructed.The pouch cell is designed at 6 Ah level with high-sulfur-loading cathodes of 7.4 mgScm^(-2),limited anode excess(50μm in thickness),and lean electrolyte(electrolyte to sulfur ratio of 1.7 gelectrolyteg^(-1)S).Accordingly,an ultrahigh specific capacity of 1563 m A h g^(-1)is achieved with the addition of a redox comediator to afford a practical energy density of 695 Wh kg^(-1)based on the total mass of all components.The pouch cell can operate stably for three cycles and then failed due to rapidly increased polarization at the second discharge plateau.According to failure analysis,electrolyte exhaustion is suggested as the key limiting factor.This work achieves a significant breakthrough in constructing high-energy-density Li–S batteries and propels the development of Li–S batteries toward practical working conditions.

Totally intracorporeal robot-assisted urinary diversion for bladder cancer(Part 1).Review and detailed characterization of ileal conduit and modified Indiana pouch

Objective:To review the most used robot-assisted cutaneous urinary diversion(CUD)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent images Methods:A non-systematic review of the literature with the keywords“bladder cancer”,“cutaneous urinary diversion”,and“radical cystectomy”was performed.Results:Twenty-four studies of intracorporeal ileal conduit(ICIC)and two of intracorporeal Indiana pouch(ICIP)were included in the analysis.Regarding ICIC,the patients’age ranged from 60 to 76 years.The operative time to perform a urinary diversion ranged from 60 to 133 min.The total estimated blood loss ranged from 200 to 1117 mL.The rate of positive surgical margins ranged from 0%to 14.3%.Early minor and major complication rates ranged from 0%to 71.4%and from 0%to 53.4%,respectively.Late minor and major complication rates ranged from 0%to 66%and from 0%to 32%,respectively.Totally ICIP data are limited to one case report and one clinical series.Conclusion:The most frequent type of CUD is ICIC.Randomized studies comparing the performance of the different types of CUD,the performance in an intra-or extracorporeal manner,or the performance of a CUD versus orthotopic ileal neobladder are lacking in the literature.To this day,there are not enough quality data to determine the supremacy of one technique.This manuscript represents a compendium of the most used CUD with detailed descriptions of the technical aspects,operative and perioperative outcomes,and new consistent images for each technique.

Endoscopic closure instead of surgery to close an ileal pouch fistula with the over-the-scope clip system

An ileal pouch fistula is an uncommon complication after an ileal pouch anal anastomosis. Most patients who suffer from an ileal pouch fistula will need surgical intervention. However, the surgery can be invasive and has a high risk compared to endoscopic treatment. The over-the-scope clip(OTSC) system was initially developed for hemostasis and leakage closure in the gastrointestinal tract during flexible endoscopy. There have been many successes in using this approach to apply perforations to the upper gastrointestinal tract. However, this approach has not been used for ileal pouch fistulas until currently. In this report, we describe one patient who suffered a leak from the tip of the "J" pouch and was successfully treated with endoscopic closure via the OTSC system. A 26-year-old male patient had an intestinal fistula at the tip of the "J" pouch after an ileal pouch anal anastomosis procedure. He received endoscopic treatment via OTSC under intravenous anesthesia, and the leak was closed successfully. Endoscopic closure of a pouch fistula could be a simpler alternative to surgery and could help avoid surgeryrelated complications.