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A laparoscopic pull-through operation for Hirschsprung's disease: report of two infant cases
Insights
This study presents a laparoscopic pull-through procedure for Hirschsprung
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Hirschsprung's disease is a congenital disorder characterized by the absence of ganglion cells in the distal bowel.
- Surgical intervention is the primary treatment for Hirschsprung's disease.
- Traditional open surgical approaches can be associated with significant morbidity in infants.
Observation:
- A primary laparoscopic pull-through procedure was successfully performed on two infants with Hirschsprung's disease.
- The procedure involved laparoscopic mobilization of the rectum and sigmoid colon, transanal submucosal resection of rectal mucosa, and a Soave-Denda coloanal anastomosis.
- Rectal prolapse was induced intussusceptically for the pull-through maneuver.
Findings:
- Both infants experienced an uneventful postoperative course.
- Early recovery of bowel movement was observed in both patients.
- The laparoscopic approach facilitated a minimally invasive treatment for Hirschsprung's disease in young infants.
Implications:
- Laparoscopic pull-through surgery is a feasible and effective treatment option for infants with Hirschsprung's disease.
- This minimally invasive technique may offer advantages over open surgery, including potentially faster recovery.
- Hirschsprung's disease is a strong indication for considering laparoscopic surgical intervention in pediatric patients.
Abstract:
We describe herein a primary laparoscopic pull-through procedure that was successfully employed to treat two infants with Hirschsprung's disease. Mobilization of the rectum and sigmoid colon was performed laparoscopically, and the rectal mucosa was removed via a transanal submucosal resection. After inducing the rectal prolapse intussusceptically, the rectum was circumferentially transected, and the mobilized colon was pulled down through the rectal muscle cuff. Resection of the aganglionic bowel and the coloanal anastomosis, using the Soave-Denda method, was performed outside the anus. Both infants had an uneventful postoperative course with early recovery of bowel movement. Our experience demonstrates that this minimally invasive surgical procedure is feasible for young infants, and we believe that Hirschsprung's disease may be a definite indication for laparoscopic surgery.