I would ask him about the possibility of cancer occurring in the un-used pouch and it going undetected. My surgeon said to me when he removed my colon and gave me an ileostomy (prior to the J-pouch) that if I wanted to live with the ileostomy he would remove my remaining colon and rectum at about the 5 year mark as there was an increased risk of cancer occurring there because it was unused. I'm not sure if the same thing goes for small intestines.