NYC - G...
Big picture ... had my pouch for 36 years ... had inguinal surgery in 2012 ... so, a fairly long time ago, in New Jersey far, far away...
I was on our couch watching the 432nd episode of Law & Order. Cuddling with my wife (who is a doc!) and I coughed. She felt something in my lower sternum. She made me cough again (and again) and said, "hey, you have a hernia!"
Fast forward to NY Presbyterian ... I contacted my colo-rectal surgeon and he recommended a colleague who was inherently familiar with my colon-less landscape.
The surgery was straightforward ... a day to recover and get discharged ... my pouch was ok throughout. I do recall that I was encouraged not to push / strain and let my movements come very naturally. Diet and lots of liquids facilitated the recovery.
And, my wife, just reminded me that the anesthesia was "MAC" -- monitored anesthesia care or conscious sedation -- a lighter state of anesthesia which reduced the likelihood that my gut might seize or collapse or just decide to take a break.
In sum, don't sweat it. Your docs need to thoroughly swap info and surgical history ... you need to take it slowly and follow the diet recommendations ... and trust in the system!
Best, Michael