Laparoscopic approach for rectosigmoidian resection in children

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Surgical Innovation

Background:

• The abdominoperineal approach for rectosigmoidian resection, pioneered by Orwar Swenson in 1948, was foundational in treating congenital megacolon.
• Subsequent modifications by Duhamel and Soave aimed to mitigate complications, introducing techniques that maintain the aganglionic rectum in transit.
• The evolution towards minimally invasive surgery began with laparoscopic replication of the Duhamel procedure in 1994 and the Swenson technique in 1995.

Purpose of the Study:

• To review the historical development and current standing of the abdominoperineal approach in congenital megacolon treatment.
• To highlight the transition from open to minimally invasive surgical techniques.
• To establish the abdominoperineal approach as the predominant method for radical treatment of congenital megacolon.

Main Methods:

• Historical review of surgical techniques for congenital megacolon.
• Tracing the evolution from open abdominoperineal resection to minimally invasive approaches.
• Analysis of seminal surgical procedures and their modifications over time.

Main Results:

• The abdominoperineal approach, originating in 1948, established the primary surgical pathway for congenital megacolon.
• Modifications by Duhamel and Soave addressed early postoperative complications.
• Minimally invasive adaptations, pioneered in the mid-1990s, have led to the current widespread use of this approach.

Conclusions:

• The abdominoperineal approach has undergone significant evolution since its inception.
• Minimally invasive surgery has become the most frequently utilized method for radical treatment of congenital megacolon.
• This surgical technique remains the gold standard for addressing congenital megacolon.