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Intestinal Lengthening Procedures: A Possible Alternative to Intestinal Transplant

An intestinal lengthening procedure may be recommended for your child if they have short bowel syndrome and are relying on TPN for nutrition. The goal of a bowel lengthening procedure is to allow food to spend more time in the digestive tract where it can be absorbed naturally into the body.

There are three main types of intestinal lengthening procedures that intestinal rehabilitation programs may offer: (1)

  • Bianchi procedure: During this procedure, the bowel is divided in half and sewed from one end to the other. The goal is to convert the intestine from one short tube with a large diameter to a longer tube with a smaller diameter. This allows for the food to travel and be absorbed into the body.

  • Serial Transverse Enteroplasty Procedure (STEP): In this procedure, the bowel is divided and stapled in a zig-zag pattern. The accordion-like pattern allows food to spend more time in the intestine where it can be absorbed naturally.

  • Ostomy in continuity: In children with short bowel syndrome with severely impaired motility, an ‘ostomy in continuity’ is constructed which enables intestinal decompression as well as absorption of nutrients.


  1. Pediatric Bowel Lengthening Surgery: Bianchi and STEP. Children's National – Ranked Top Five Children's Hospital in the Nation. Accessed April 30, 2020.

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