Vall d'Hebron performed a pioneering operation in the world as an alternative to intestinal transplantation

Professionals from the Vall d'Hebron Pediatric Surgery Service performed the first described intervention in the world to lengthen the duodenum as an alternative to transplantation in patients with short bowel syndrome.

February 2013

In February 2013, Àlex, a 7-year-old boy with short bowel syndrome, was the first patient to undergo this technique. Short bowel syndrome is a disease that involves the loss of a large segment of the small intestine. People with short bowel syndrome cannot absorb food properly and, for this reason, must be permanently connected to a device that supplies them with food through a vein, to replace their nutritional deficiencies. This artificial nutrition can generate many complications, whether hepatic, infectious, etc., and, in the long term, the only solution is an intestinal transplant.

Àlex was admitted to Vall d'Hebron when he was one month old with a torsion of his small intestine that was cutting off his blood supply and causing intestinal necrosis. He required up to 18 surgical interventions to remove the parts of the intestine that were no longer functioning, so he lost all of his small intestine except for the duodenum and part of the large intestine.

For this reason, Àlex had been fed artificially throughout his life and was a strong candidate for an intestinal transplant, with all the risks that this entails. So far, two surgical techniques for intestinal lengthening had been described; but neither of them used the duodenum, since it is a segment of the intestine that is difficult to approach from a surgical point of view.

Classic intestinal lengthening techniques require, at least, a segment of small intestine that Àlex did not have. The new technique that was used provided the possibility of adding a segment of intestine, the duodenum, which had never been used before. This fact further increases the patient's food absorption and reduces the need for artificial nutrition.

A year after the intervention, Àlex was already eating independently, that is, he was able to do without artificial nutrition and did not require any extra feeding device and, therefore, the much-feared intestinal transplant had been avoided.

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