Treatments / Surgery

Appendicostomy (Malone Procedure)

It is important to stress that the Malone procedure is just another way to administer an enema and therefore, before performing the operation, the child has to be perfectly clean with a bowel management regimen.

Appendicostomy illustration: The appendix is connected to the belly button so a tube can be passed through it for the enema administration.

The operation consists of connecting the appendix to the umbilicus, and creating a valve mechanism that allows catheterization of the appendix for the enema fluid, but avoids leakage of stool through it. The operation involves a small incision below the belly button and sometimes can be done with the help of laparoscopy to minimize the incision. It takes approximately two hours to complete. We prefer the use of the appendix rather than an artificial device because it is cosmetically more hidden, and it avoids problems with the device caused by irritation of the surrounding skin.

Appendix before connection to belly button. Appendix connected to the belly button.