Surgeons Develop New Procedure for Short Bowel Syndrome

A simple new procedure to treat short bowel syndrome (SBS), called serial transverse enteroplasty (STEP), has been developed by two surgeons and has been used on four patients to date.

SBS is a deadly disorder caused by surgical removal of part of the small bowel or by disease, in which the remaining bowel grows wider, slowing digestion and breeding bacteria. In the past, surgeons used the Bianchi Procedure to treat the condition. In this procedure, the bowel is cut in half and one end is sewn to the other, but the bowel often re-dilates, leaving patients in the same condition.

Heung Bae Kim, M.D., an assistant in surgery at Children's Hospital (Boston, MA, USA), had a concept for a better procedure, which he shared with Tom Jaksic, M.D., Ph.D., associate in surgery at Children's Hospital. Together, the two doctors developed the new STEP procedure, based on the idea that stapling v-shapes into alternating sides of the bowel with an ordinary surgical stapler would decrease its width and increase its length.

After testing the procedure successfully in pigs, the two surgeons first used it in February 2002 on a two-year-old boy with SBS. So far, his bowel has not dilated again and he is doing well. Drs. Kim and Jaksic have since used the procedure on three other children. Post-surgical studies show that food moves more quickly through the small bowel after the STEP procedure and nutrients are absorbed more completely, both of which lead to less bacterial growth and healthier children. Because the STEP concept is simple, the procedure can easily be taught to other surgeons.




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