Surgical repair of prolapsed stoma via the buttonpexy approach: a case series

Stoma prolapse is a frequent complication following stoma formation in pediatric patients and often necessitates surgical intervention. The buttonpexy technique offers a minimally invasive, low-cost, and anesthesia-sparing alternative to formal stoma revision. This case series highlights its safety and effectiveness in managing pediatric stoma prolapse. Five pediatric patients with stoma prolapse secondary to various underlying conditions, including anorectal malformation, Hirschsprung's disease, and Currarino syndrome, were managed using the buttonpexy technique. In each case, the prolapsed bowel was gently reduced, and pledgets derived from intravenous tubing were secured above and below the skin margins to anchor the stoma locally. The procedures were performed under local anesthesia, and all patients tolerated them well. Four patients demonstrated complete resolution without recurrence during follow-up, while one experienced partial prolapse that was successfully corrected with a repeat buttonpexy. None of the patients required conversion to formal stoma revision, and no complications such as infection, necrosis, or bleeding were observed. Follow-up ranged from one to eight months, confirming sustained stoma stability until definitive closure. The buttonpexy technique is a simple, safe, reproducible method for managing pediatric stoma prolapse. It can be performed under local anesthesia, minimizing anesthetic exposure and hospital stay. This approach provides a practical first-line option before considering formal revision, especially in resource-limited or pediatric settings where minimizing surgical and anesthetic risks is paramount.