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Related Experiment Videos

Extra-anal mucosectomy: laparascopic-assisted endorectal pull-through using a prolapsing technique

Y Morikawa1, K Hoshino, K Matsumura

  • 1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.

Journal of Pediatric Surgery
|December 18, 1998
PubMed
Summary

This study introduces an extra-anal mucosectomy technique for Hirschsprung disease surgery. This innovative approach improves the operative view during the Soave procedure, enhancing surgical outcomes.

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Area of Science:

  • Pediatric surgery
  • Gastrointestinal surgery
  • Surgical innovation

Background:

  • The Soave procedure for Hirschsprung disease traditionally involves transabdominal mucosectomy.
  • Transanal mucosectomy, while recently reported, offers restricted operative views due to dissection within the anal canal.
  • A need exists for improved visualization and surgical access during rectal mucosectomy.

Purpose of the Study:

  • To report an innovative extra-anal mucosectomy technique for the Soave procedure.
  • To combine this technique with laparoscopic-assisted prolapsing for Hirschsprung disease treatment.
  • To overcome the limitations of restricted operative fields in traditional transanal approaches.

Main Methods:

  • Laparoscopic surgery was performed on four patients with Hirschsprung disease using an extra-anal mucosectomy approach.

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  • The rectum was everted through the anal canal to create a prolapse for external dissection.
  • Mucosectomy was completed outside the anal canal under direct observation, followed by colonic anastomosis.

    • Main Results:

    • The extra-anal mucosectomy allowed for complete mucosectomy under direct visualization.
    • This technique facilitated improved operative view and working field compared to transanal methods.
    • Mean operative time was 3 hours.

    Conclusions:

    • Extra-anal mucosectomy combined with laparoscopic-assisted prolapsing is a safe and reliable surgical option for Hirschsprung disease.
    • The technique enhances visualization and potentially simplifies the mucosectomy step.
    • Further studies may validate its long-term efficacy and benefits.