Antonino Morabito, Chair Surgery
Pediatric autologous bowel reconstruction and rehabilitation unit
The Meyer model
The Intestinal Rehabilitation Program (IRP) at the Meyer Children’s Hospital - Firenze is a multidisciplinary program that provides consultation, advice, management, support and long-term follow-up for children and their families coping with complex intestinal disorders leading to short bowel syndrome and intestinal failure.
Our experienced team cares for patients from around the world and has an enviable worldwide reputation supported by published data for innovation and outcome-driven care.
The individualised approach to intestinal reconstruction and rehabilitation is the key to our success. Each patient has his/her own program tailored to his/her needs.
Intestinal rehabilitation includes strategies and therapies designed to optimise native bowel function, such as nutritional support, nutritional rehabilitation, medical management and reconstructive surgery.
Reconstructive surgery is an integral part of the program. Combined autologous reconstructive techniques are employed to address the main clinical problems of the short bowel syndrome: diminished bowel length and transit time.
Patients receive comprehensive care from a team of experts that includes:
- paediatric surgeons
- gastroenterologists
- neonatologists
- nurse coordinators
- psychologist
- dieticians
- rehabilitation therapists
- speech-language, feeding and play specialists
- social worker
Nurse and Social Workers coordinators are readily accessible and play a central role within the healthcare team. Clinical psychologists work with families to improve family/patient compliance with therapy.
Conditions treatedOur team cares for patients with short bowel syndrome and intestinal failure resulting mainly from the following intestinal disorders:
- Short bowel syndrome / Short gut syndrome – This is a consequence not a primary aetiology
- Bowel atresias
- Gastroschisis
- Hirschsprung disease
- Intestinal atresia
- Malabsorption diseases and disorders
- Malrotation
- Necrotizing enterocolitis
- Omphalocele-extrophy-imperforate anus-spina bifida (OEIS)
- Pseudo-obstruction
- Total parenteral nutrition-induced liver disease
- Volvulus
The individualised approach to intestinal reconstruction and rehabilitation is the key to our success. Each patient has his/her own program tailored to his/her needs.
Our innovative medical and surgical interventions account for the high success rate we have for weaning patients off parenteral nutrition. We use lipid-sparing protocols and IV fish-oil-based lipids in a select group of patients.
We believe that in future these conditions can be treated using autologous bowel (patients’ own bowel). Our group has commenced research into molecular/physical mechanisms and/or growth factors that can elongate the bowel using ex vivo models. We are pioneering the use of physical expanders to dilate segments of bowel in order to optimise the subsequent surgical lengthening processes. We are constantly trying to challenge previous boundaries of treatment and are aiming to explore the use of organoid or 3d bio-printed scaffolds to create new bowel.
Our prior successes and on-going innovations are evidenced by publications in peer review journals.
We provide help and support for the families. Helping and supporting a sick child fighting a chronic illness is a huge emotional (and sometimes financial) toll that can affect all family members. We provide housing near the hospitalized child, at no expense for the family.