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Laparoscopic appendicostomy for management of fecal incontinence
H W Webb1, M A Barraza, J M Crump
1Nemours Children's Clinic, Jacksonville, FL 32207, USA.
Insights
Laparoscopic appendicostomy offers a minimally invasive option for antegrade colonic enemas, improving fecal incontinence management in select young patients with disabilities. This technique provides an alternative to open surgery for improved psychosocial development.
Area of Science:
- Pediatric Surgery
- Colorectal Surgery
- Minimally Invasive Surgery
Background:
- Fecal incontinence significantly impacts psychosocial development in children with disabilities.
- Existing antegrade colonic enema procedures address this issue.
- There is a need for alternative surgical approaches.
Purpose of the Study:
- To describe laparoscopic appendicostomy as a method for establishing proximal colon access.
- To evaluate the efficacy of this technique in managing fecal incontinence.
Main Methods:
- A laparoscopic approach was used to create appendicostomy for antegrade colonic enemas.
- The procedure was performed in a select group of patients requiring fecal incontinence management.
Main Results:
- Laparoscopic appendicostomy was successful in a select group of patients.
- The procedure yielded excellent results in managing fecal incontinence.
- This method provides an alternative to open surgery.
Conclusions:
- Laparoscopic appendicostomy is a viable option for select patients with fecal incontinence.
- The procedure is recommended when open surgery is not otherwise indicated.
- This technique can improve quality of life for affected children.
Abstract:
Fecal incontinence from any cause is a socially unacceptable condition and a major detriment to educational and psychosocial development in young people with certain disabilities. Recently several procedures have been described that allow antegrade colonic enemas in the treatment of this problem. We report here an additional method of establishing this proximal colon access, namely laparoscopic appendicostomy. Although not applicable to all patients, this procedure has been successful in a select group with excellent results, and we recommend its consideration when open surgery is not otherwise required.