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Small intestinal lengthening by the Bianchi procedure has now had successful clinical application in children and neonates with the short-bowel syndrome. This paper reviews the background experimental work and clinical cases so far treated. A personal case of intestinal lengthening in a 7-week-old baby with 35 cm jejunum is described in detail. Intestinal lengthening appears to reduce dependence on parenteral nutrition, thus allowing earlier establishment of total enteral alimentation. The procedure may therefore have a useful place in the overall management of the short-bowel syndrome.