As children enter school full-time, they made need adjustments made to their treatment plan and program. Although bowel reconstruction surgery can repair the anatomy, it does not always restore nerve and muscle function needed to provide the body cues that it has to go to the bathroom. In addition to participating in a bowel management program that treats children using non-surgical techniques, some children that have had bowel reconstruction may require an additional surgery called a Malone appendicostomy.
This procedure is an option for older children who can successfully keep themselves clean and can manage the responsibility of administering enemas themselves. The procedure involves a surgeon creating a pathway or “valve” from the appendix to the belly button using the child’s own tissue. The valve is catheterized, allowing enema fluid to be administered into the colon to flush out stool. The procedure is performed using laparoscopic techniques (a minimally invasive surgical technique that avoids large incisions). Laparoscopic surgery allows for faster recovery times, shorter hospital stays and less pain.
About a month post-surgery, the catheter is removed and the child and parents are able to deliver the daily enemas through the valve to successfully flush the colon on their own. The valve remains hidden (but open) in the abdomen, allowing the child to bathe and shower freely.