The cecostomy button

Percutaneous insertion of a cecostomy tube, performed under local anesthesia, to facilitate antegrade colonic cleansing, has been an invaluable advance in the management of fecal incontinence, However, the patient is left with a length of tubing (2 to 4 inches) protruding from the cecostomy site that has to be taped down to the abdominal wall, Available devices for insertion in place of the cecostomy tube are cumbersome and have a relatively high profile, projecting more than 1 cm from the surface of the abdominal wall. Worn under a swimsuit, they are clearly discernible. The inflated balloon within the cecum can occasionally break, Furthermore, in the individual with a relatively thick abdominal wall, such devices are too short to reach from the skin to the cecum, A new form of low-profile trapdoor device has been developed that overcomes the above shortcomings of other available ''buttons.'' It has been successfully used in a clinical setting in 49 patients. Copyright (C) 1997 by W.B. Saunders Company.