As a child gets older, they often begin to want more privacy around potty time. Most older children say that they like the independence and privacy that the procedure gives them. For the procedure, surgeons will connect the appendix to the belly button, and create a valve that allows the appendix to be catheterized. The valve lets the enema fluid in without allowing stool to leak out. The procedure is usually done with laparoscopic equipment avoiding incisions and takes about two hours to complete.
Antegrade Continence Enema (ACE)
Antegrade Continence Enema (ACE) (for Parents) - KidsHealth
This usually uses the appendix to create a channel from the skin into the large bowel at a point called the caecum. The fluid used to wash out the bowel can then be inserted easily. This fluid flushes the faeces out through the rectum in the usual way. This is called a stoma artificial opening. If your child has already had their appendix removed or if it is not suitable, the surgeon may need to use another method to create the passage. Your child will come back to the ward to recover. Do not rub the stoma site as this will make it sore.
Long-term Follow-up of Patients After Antegrade Continence Enema Procedure
An antegrade continence enema is a different way to give an enema. Enemas can help someone poop if they become constipated or have another problem moving their bowels. The most common type of enema EN-eh-muh puts liquid directly into the rectum, the last part of the large intestine, to help release poop. It's simple to do and does not involve any kind of surgery. But because these start at the end of the large intestine also called the colon or bowel rather than the beginning, they work backward from how we move our bowels naturally.
Patients may present with anal incontinence AI following repair of a congenital anorectal anomaly years previously, or require total anorectal reconstruction TAR following radical rectal extirpation, most commonly for rectal cancer. Others may require removal of their colostomy following sphincter excision for Fournier's gangrene, or in cases of severe perineal trauma. Most of the data pertaining to antegrade continence enema the ACE or Malone procedure comes from the pediatric literature in the management of children with AI, but also with supervening chronic constipation, where the quality of life and compliance with this technique appears superior to retrograde colonic washouts. The advantages and disadvantages of these techniques and their outcome are presented here.