My former ostomy nurse told me she had a patient, an adult man, who had this procedure done a long time ago. His life is very difficult because his small intestine was joined directly to his anus. He now has short bowel syndrome (I think that's what it's called) and anything he eats goes right through him. He is constantly Searching for toilets, and he suffers constant leakage. If it were my son, I would search for a top notch surgeon who has the skill to give a 10 year old a relatively normal life, not lifelong incontinence. Your boy has a long life ahead. Maybe this direct-connect procedure is the only one your surgeon knows how to perform. Maybe anything more complicated is beyond his skill set right now. It's not an insult to your surgeon (or any surgeon) if you get a second or third opinion. Search the world over to give your child the best outcome. He is too young to make the decision, so you have to do everything you can.