Related Experiment Video
Updated: Jul 10, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Primary laparoscopic repair of high imperforate anus in neonatal males
Laura R Vick1, John R Gosche, Scott C Boulanger
1Division of Pediatric Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA.
Insights
This study shows that primary laparoscopic repair is a safe and effective single-stage procedure for high imperforate anus in newborn males. This minimally invasive approach avoids the need for a colostomy, offering encouraging early results.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Congenital Anomalies
Background:
- The traditional treatment for high imperforate anus involves a staged approach with colostomy followed by posterior sagittal anorectoplasty.
- Minimally invasive techniques are emerging as alternatives for treating imperforate anus.
Purpose of the Study:
- To evaluate the feasibility and early outcomes of a primary, single-stage laparoscopic repair for high imperforate anus in newborn males.
- To compare this approach to the conventional staged procedure.
Main Methods:
- A retrospective chart review of newborn males with high imperforate anus treated between October 2003 and October 2006.
- Analysis of patients who underwent primary laparoscopic repair on days 1-2 of life.
Main Results:
- Six out of nine evaluated patients underwent primary laparoscopic repair.
- Fistula types included bladder neck (3 patients) and prostatic urethra (3 patients).
- All patients achieved postoperative stool passage within 72 hours; one required a procedure for rectal prolapse.
Conclusions:
- Primary laparoscopic repair of high imperforate anus is a promising single-stage option.
- Laparoscopy provides excellent visualization for fistula assessment and repair, eliminating the need for colostomy.
- Further long-term follow-up is necessary to confirm outcomes and continence rates.
Purpose:
The standard approach to males with high imperforate anus has been a staged procedure starting with a descending colostomy, then posterior sagittal anorectoplasty with colostomy closure after 3 months. Recently, a minimally invasive approach to the repair of high imperforate anus has been described in infants after colostomy. We describe 6 newborn males with high imperforate anus successfully repaired laparoscopically as a primary, single-stage procedure.
Methods:
A retrospective chart review was performed on all patients with imperforate anus from October 2003 to October 2006.
Results:
We evaluated 9 newborn males with high imperforate anus. Of these patients, 6 underwent primary laparoscopic repair on day 1 to day 2 of life. Of these 6 patients, 3 were found to have bladder neck fistulas, whereas the other 3 had prostatic urethra fistulas. All patients passed stool within the first 72 hours postoperatively. One patient has required a procedure for a mild rectal prolapse. Follow-up ranges from 2 to 30 months in the single-stage group.
Conclusion:
Our early results using primary laparoscopic repair appear encouraging. Laparoscopy allows excellent visualization and assessment of the fistula and repair of high imperforate anus without need for colostomy. Long-term follow-up will be needed to assess outcomes and continence rates.