Laparoscopic caecodivision ACE (antegrade continence enema) procedure

Area of Science:

• Surgical innovation
• Minimally invasive surgery
• Pediatric surgery

Background:

• The antegrade colonic enema (ACE) procedure, first described by Malone in 1990, is a surgical technique used to treat fecal incontinence.
• Multiple modifications have aimed to improve the original ACE procedure.
• The use of the appendix as a conduit is a common feature of the ACE procedure.

Observation:

• The authors describe a novel modification of the ACE procedure.
• This modification involves a laparoscopic caecodivision technique.
• The appendix is not utilized in this described method.

Findings:

• This report details the first laparoscopic caecodivision method for the ACE procedure.
• The technique integrates the benefits of laparoscopic surgery.
• It also incorporates the advantage of not using the appendix.

Implications:

• This laparoscopic approach may offer advantages over traditional open ACE procedures.
• The avoidance of the appendix could simplify the procedure or reduce potential complications.
• Further research is warranted to evaluate the long-term outcomes and efficacy of this technique.