title: Laparoscopic insertion of antegrade continence enema catheter:  a technique enabling early postoperative usage.
abstract: OBJECTIVE
  The Chait Trapdoor Caecostomy catheter was developed to allow the use of antegrade continence enemas without using the appendix. We describe a technique for its insertion under laparoscopic guidance.
  
  
  METHODS
  Bowel is secured to the abdominal wall using nonabsorbable sutures. Technical details of the procedure are described.
  
  
  RESULTS
  Five children underwent the procedure. Four had a left-sided procedure and tolerated the procedure well without complications. They have good results with daily antegrade enemas. One child who had a cecostomy had postoperative abdominal distension. He has ongoing soiling and constipation, but has problems with compliance.
  
  
  CONCLUSIONS
  We have used the technique in a small number of patients, but results have been favorable. The sutures prevent the risk of the bowel segment slipping from the tube when distended with fluid, provide a good seal around the tube to avoid leakage, and keep a smooth alignment of bowel without angulation.
authors.affiliation: Department of Paediatric Surgery, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK. cmholbrook_9@hotmail.com
authors.forename: Charlotte
authors.initials: C
authors.lastname: Holbrook
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsang
mesh_terms: D000293:Adolescent; D002404:Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000601:surgery*; D004733:Enema / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010710:Phosphates / Q000008:administration & dosage; D011182:Postoperative Care; D013537:Sutures
chemical_list: D010710:Phosphates