THE CECOSTOMY BUTTON

Percutaneous insertion of a cecostomy tube, performed under local anes thesia, to facilitate antegrade colonic cleansing, has been an invalua ble advance in the management of fecal incontinence, However, the pati ent is left with a length of tubing (2 to 4 inches) protruding from th e cecostomy site that has to be taped down to the abdominal wall, Avai lable devices for insertion in place of the cecostomy tube are cumbers ome and have a relatively high profile, projecting more than 1 cm from the surface of the abdominal wall. Worn under a swimsuit, they are cl early discernible. The inflated balloon within the cecum can occasiona lly break, Furthermore, in the individual with a relatively thick abdo minal wall, such devices are too short to reach from the skin to the c ecum, A new form of low-profile trapdoor device has been developed tha t overcomes the above shortcomings of other available ''buttons.'' It has been successfully used in a clinical setting in 49 patients. Copyr ight (C) 1997 by W.B. Saunders Company.