Endoscopic Full-Thickness Resection Biopsy Using Ovesco Diagnostic FTRD® as a Tool to Diagnose Hirschsprung's Disease...

Hirschsprung's disease is a congenital anomaly affecting intestinal motility. Its main characteristic is the absence of ganglion cells in the distal colon, which results in chronic constipation. To date, confirmatory biopsies in the pediatric population have been obtained through suction biopsies or open surgical procedures. Therapeutic endoscopic full-thickness resection (EFTR) has been successfully used in adult endoscopy to treat various diseases of the lower gastrointestinal tract. This procedure has been shown to be safe and effective.

A single-center retrospective case series study from May 2024 to September 2025, including 13 pediatric patients aged 3.5-14.4 years (median 9.5 years) with therapy-refractory constipation, who underwent an EFTR biopsy using Ovesco diagnostic FTRD® as part of the diagnostic workup for Hirschsprung's disease. EFTR was performed in the distal rectum, 2 cm above the linea dentata, to exclude an ultrashort variant of Hirschsprung's disease.

All EFTR procedures were successful, and only 1 patient had non-hemodynamically relevant rectal bleeding during the 1-year follow-up. All biopsies fulfilled the requirements to validate or exclude Hirschsprung's disease, showing an excellent success rate of full-thickness resection (100%).

This is the first case series of EFTR using the Ovesco diagnostic FTRD® technique in pediatric patients for the diagnosis of Hirschsprung's disease. EFTR is a safe, time-saving, and successful method that can be used to diagnose Hirschsprung's disease in pediatric patients starting from 3 years of age.