Malone antegrade continence enema

A Malone antegrade continence enema (MACE), also known as an appendicostomy or Malone procedure, is a surgical procedure used to create a continent pathway proximal to the anus that facilitates fecal evacuation using enemas.

[1] If the appendix was previously removed or is unusable, a neoappendix can be created with a cecal flap.

A percutaneous cecostomy tube (C-tube)[4] is an alternative to a MACE.

It involves the surgical insertion of a catheter into the cecum for the same goal (of performing enemas).

Percutaneous cecostomy procedures, like MACEs, have been performed laparoscopically.

A. Button device in the cecum via the appendix. B. Close-up view of the appendix, wrapped with cecum, and a tube in the channel. C. View of how the device looks connected to the abdominal wall – with catheterization access above and indwelling balloon device below.