Laparoscopic continent appendicostomy in the management of fecal incontinence and constipation

Abstract

The antegrade colonic enema (ACE) through the appendix was introduced by Malone et al. (1990) for the management of fecal incontinence. It has also been advocated for intractable constipation (Griffiths and Malone 1995; Squire et al. 1993; Wilcox and Kiely 1998). There is no doubt that ACE has dramatically changed the quality of life of many of the children with these problems. Leakage of the appendicostomy however is one of the problems and antireflux mechanisms to prevent it have been proposed. We have been creating appendicostomies with an antireflux mechanism laparoscopically with good results. The technique is presented here. © Springer-Verlag Berlin Heidelberg 2008.