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An appendicostomy is the creation of a pathway from your belly button to the large intestine. The pathway is created using your own body tissue, the appendix. Using your own body tissue instead of an artificial tube will decrease the chance of irritation.
An appendicostomy is done to help deliver enemas more easily. Enemas are fluids that are placed into the large intestines to soften stool and relieve constipation. The fluids help clean out the intestines when there is a problem with the intestines or stool. Enemas may be needed in children with Spina bifida, spinal injuries, Hirschprung’s disease, or constipation not relieved by medical care.
Enemas are normally given through the rectum. This can make it difficult for people to deliver the enemas to themselves. For older children, it can be difficult to have rectal enemas delivered by their parents. An appendicostomy can allow more independence for these children.
Your doctor will need to make sure that enemas are effective for your condition. You will also need to show good fecal control with enemas. Good control is staying clean for at least 24 hours after emptying your bowels.
You may need to stop taking some medicines up to one week before the procedure.
General anesthesia is used. You will be asleep during the procedure.
A small cut will be made just below the bellybutton. The tip of the appendix will also be opened. The opened end will then be attached to an opening in the belly button. If the appendix has been removed previously, a new one will be created from the large intestine. A valve will then be placed at this connection. The valve allows the enema to flow in but keeps fluids from leaking out.
A tube will be passed through the belly button and valve. The tip of the tube will stay in the appendix. The end of the tube will remain outside of the bellybutton. The tube will be taped into place. This tube will stay in place for 2-4 weeks after the surgery until the area heals.
Appendicostomy (Malone Procedure). Cincinnati Children’s Hospital website. Available at: ...(Click grey area to select URL) Accessed October 21, 2012.
Appendicostomy. Intermountain Healthcare website. Available at:
https://intermountainhealthcare.org/ext/Dcmnt?ncid=521117329. Accessed October 21, 2012.
Levitt MA, Soffer SZ, Péan A. Continent appendicostomy in the bowel management of fecally incontinent children.
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Taiwo A. Lawal, Shawn J. Rangel, Andrea Bischoff, Alberto Peña, and Marc A. Levitt. Journal of Laparoendoscopic & Advanced Surgical Techniques. June 2011, 21(5): 455-459.
Last reviewed June 2014 by Michael Woods, MD
Last Updated: 6/24/2013
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