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Pediatric Bowel Lengthening Surgery: Bianchi and STEP

We may recommend a bowel lengthening procedure for children with short bowel syndrome. Children with short bowel syndrome cannot absorb the necessary nutrients and fluids and often need to receive total parenteral nutrition (TPN, or intravenous feeding).

The goal of bowel lengthening procedures is to allow food to spend more time in the digestive system, where it can be absorbed naturally into the body.

Bowel Lengthening Procedures at Children’s National

Children in our Intestinal Rehabilitation Program receive the full spectrum of care from our dedicated staff. We may recommend bowel lengthening surgery for children who do not respond to medical therapy or do not experience sufficient relief from symptoms. Features of our surgical care include:

  • Expertise. Our team includes nationally renowned experts in intestinal failure, including pediatric surgeons and a pediatric anesthesiologist, available 24/7 for your child’s needs. Read more about anesthesia at Children’s National.
  • Personalized care. We have the experience and expertise in all types of bowel lengthening procedures, including the Bianchi and STEP procedures. We don’t practice cookie-cutter care—we believe in choosing the approach that works best for your child.
  • Advanced operating rooms. Our 17 sophisticated operating rooms are equipped with advanced monitoring technology, allowing us to perform precise, effective surgery. We perform laparoscopic and traditional open surgery, depending what offers your child the optimal results.

Bowel Lengthening Procedures for Short Bowel Syndrome

We offer several procedures, with their own advantages and risks. We will discuss the procedures with you in detail and choose the most appropriate approach for your child.

The procedures are:

  • Bianchi procedure. During this procedure, your child’s surgeon divides the bowel in half and sews one end to the other. The goal is to convert the intestine from one short tube with a large diameter to a longer tube with a smaller diameter. This allows more time for food to travel and be absorbed into the body.
  • Serial transverse enteroplasty procedure (STEP). Your child’s surgeon divides the bowel and staples it in a zigzag pattern. The accordion-like pattern allows food to spend more time in the intestine where it can be absorbed naturally.
  • Ostomy in continuity: In children with short bowel and severely impaired motility, we construct and “ostomy in continuity” which enables intestinal decompression as well as absorption of nutrients

Surgery for Children: Family Resources

Our goal is to maximize the quality of our patients’ lives and ease the stress on families. Children’s National provides many family-centered services because we understand that when a child is ill, it affects the entire family.

Learn more about:

Contact Us

For more information, call us at 1-202-476-2458.



Intestinal Rehabilitation Program

Our intestinal rehabilitation experts provide advanced, comprehensive services for children with intestinal failure.

General and Thoracic Surgery

The pediatric surgical experts at Children’s National in Washington, D.C., provide advanced, comprehensive surgical care for infants, children and teenagers.

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