Aims: 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.