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Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure
Heung Bae Kim1, Dario Fauza, Jennifer Garza
1Department of Surgery, Children's Hospital and Harvard Medical School, and Harvard Center for Minimally Invasive Surgery, Boston, Massachusetts 02115, USA.
Journal of Pediatric Surgery
|March 13, 2003
Summary
Serial transverse enteroplasty (STEP) effectively lengthens the bowel in pigs without obstruction, offering a safer alternative for short bowel syndrome treatment. This innovative technique shows promise for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Short bowel syndrome necessitates intestinal lengthening procedures.
- Current methods carry risks, including anastomosis complications and compromised blood supply.
- A simpler, safer technique is needed for pediatric patients.
Purpose of the Study:
- To establish the technical principles of a novel bowel lengthening procedure.
- To evaluate the safety and efficacy of serial transverse enteroplasty (STEP).
- To provide a potentially safer alternative for children with short bowel syndrome.
Main Methods:
- A reversed intestinal segment was used to induce dilation in young pigs (n=6).
- Serial transverse enteroplasty (STEP) was performed using a GIA stapler to create a zig-zag channel.
- Radiologic studies and morphometric analysis compared the lengthened segment to a control over six weeks.
Main Results:
- Animals gained weight post-procedure with no signs of obstruction.
- Intraoperative lengthening was significant (49.2 cm to 82.8 cm).
- Six weeks later, the STEP segment remained significantly longer (57.2 cm to 80.7 cm) without diameter changes.
Conclusions:
- Serial transverse enteroplasty (STEP) significantly increases intestinal length.
- The procedure demonstrated no evidence of intestinal obstruction in the study.
- STEP presents a safe and facile alternative for intestinal lengthening in short bowel syndrome.