[Surgical treatment of high-type imperforate anus: role of laparoscopy]

Two anomalies must be corrected in high-type imperforate anus: first, the rectal end is located above the puborectalis muscle, and there is a fistula between the rectum and the urinary tract (male) or the vagina (female). The standard approach is posterior sagittal anorectoplasty, as described by De Vries and Peña, which requires midline section of the muscle complex. Georgeson first reported laparoscopically assisted anorectal pull-through in 2000. This approach offers many advantages, such as division of the fistula under direct visual control, better visualization of the anatomical components of the pelvic floor, and especially avoidance of muscle section. Long-term follow-up will be needed to assess continence outcomes.