Abstract
For patients with longer segment Hirschsprung’s disease (HSCR), the bowel lacking ganglion cells is unable to be removed adequately by transanal pull-through operation alone. Several years ago, the dilated bowel had to be dissociated by a laparotomic procedure which left striking scars and severe trauma. Recently, advances in laparoscopic techniques and instruments provide minimally invasive possibilities for the management of patients with long-segment HSCR, total colonic aganglionosis, and allied HSCR disorders. The three most popular procedures, Soave, Duhamel, and Swenson, have been proven to be feasible under laparoscopic assistance, and a series of modified operations, such as heart-shaped anastomosis, have also been shown to be successful and effective. Laparoscopy has also been shown to be feasible for reoperation. With the advantages of better cosmetics, less secondary injuries, shorter hospital stay, and easier biopsy, increasingly more pediatric surgeons have made the laparoscopic procedure their first choice for children with HSCR, especially for long-segment disease. This chapter will give up-to-date knowledge on the indications, procedures, and complications of the laparoscopically assisted pull-through operation for HSCR.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Antao B, Radhwan T, Samuel M, Kiely E. Short-pouch and low-anastomosis Duhamel procedure results in better fecal control and normal defecation pattern. Dis Colon Rectum. 2005;48(9):1791–6.
Bonnard A, de Lagausie P, Leclair MD, Marwan K, Languepin J, Bruneau B, Berribi D, Aigrain Y. Definitive treatment of extended Hirschsprung’s disease or total colonic form. Surg Endosc. 2001;15(11):1301–4.
Bradnock TJ, Walker GM. Evolution in the management of Hirschsprung’s disease in the UK and Ireland: a national survey of practice revisited. Ann R Coll Surg Engl. 2011;93(1):34–8.
Carvalho JL, Campos M, Soares-Oliveira M, Estevao-Costa J. Laparoscopic colonic mapping of dysganglionosis. Pediatr Surg Int. 2001;17(5–6):493–5.
Cheung ST, Tam YH, Chong HM, Chan KW, Mou WC, Sihoe DY, Lee KH. An 18-year experience in total colonic aganglionosis: from staged operations to primary laparoscopic endorectal pull-through. J Pediatr Surg. 2009;44(12):2352–4.
Craigie RJ, Conway SJ, Cooper L, Turnock RR, Lamont GL, Baillie CT, Kenny SE. Primary pull-through for Hirschsprung’s disease: comparison of open and laparoscopic-assisted procedures. J Laparoendosc Adv Surg Tech A. 2007;17(6):809–12.
Curran TJ, Raffensperger JG. The feasibility of laparoscopic swenson pull-through. J Pediatr Surg. 1994;29(9):1273–5.
Curran TJ, Raffensperger JG. Laparoscopic Swenson pull-through: a comparison with the open procedure. J Pediatr Surg. 1996;31(8):1155–6; discussion 1156–1157
de Lagausie P, Bruneau B, Besnard M, Jaby O, Aigrain Y. Definitive treatment of Hirschsprung’s disease with a laparoscopic Duhamel pull-through procedure in childhood. Surg Laparosc Endosc. 1998;8(1):55–7.
Georgeson KE, Cohen RD, Hebra A, Jona JZ, Powell DM, Rothenberg SS, Tagge EP. Primary laparoscopic-assisted endorectal colon pull-through for Hirschsprung’s disease: a new gold standard. Ann Surg. 1999;229(5):678–82; discussion 682–683
Georgeson KE, Fuenfer MM, Hardin WD. Primary laparoscopic pull-through for Hirschsprung’s disease in infants and children. J Pediatr Surg. 1995;30(7):1017–21; discussion 1021–1022
Ghirardo V, Betalli P, Mognato G, Gamba P. Laparotomic versus laparoscopic Duhamel pull-through for Hirschsprung disease in infants and children. J Laparoendosc Adv Surg Tech A. 2007;17(1):119–1123.
Giuliani S, Betalli P, Narciso A, Grandi F, Midrio P, Mognato G, Gamba P. Outcome comparison among laparoscopic Duhamel, laparotomic Duhamel, and transanal endorectal pull-through: a single-center, 18-year experience. J Laparoendosc Adv Surg Tech A. 2011;21(9):859–63.
Hebra A, Smith VA, Lesher AP. Robotic Swenson pull-through for Hirschsprung’s disease in infants. Am Surg. 2011;77(7):937–41.
Jiao C, Yu D, Li D, Wang G, Feng J. A long-term follow-up of a new surgery method: laparoscope-assisted heart-shaped anastomosis for Hirschsprung’s disease. J Laparoendosc Adv Surg Tech A. 2018;28(4):471–5.
Kohno M, Ikawa H, Fukumoto H, Okamoto S, Masuyama H, Konuma K. Usefulness of endoscopic marking for determining the location of transanal endorectal pull-through in the treatment of Hirschsprung’s disease. Pediatr Surg Int. 2005;21(11):873–7.
Kumar R, Mackay A, Borzi P. Laparoscopic Swenson procedure – an optimal approach for both primary and secondary pull-through for Hirschsprung’s disease. J Pediatr Surg. 2003;38(10):1440–3.
Lamas-Pinheiro R, Henriques-Coelho T, Carvalho JL, Correia-Pinto J. Duhamel pull-through assisted by transrectal port: a hybrid natural orifice transluminal endoscopic surgery approach. J Pediatr Surg. 2012;47(10):1962–5.
Langer JC. Persistent obstructive symptoms after surgery for Hirschsprung’s disease: development of a diagnostic and therapeutic algorithm. J Pediatr Surg. 2004;39(10):1458–62.
Levitt MA, Dickie B, Pena A. Evaluation and treatment of the patient with Hirschsprung disease who is not doing well after a pull-through procedure. Semin Pediatr Surg. 2010;19(2):146–53.
Levitt MA, Hamrick MC, Eradi B, Bischoff A, Hall J, Pena A. Transanal, full-thickness, Swenson-like approach for Hirschsprung disease. J Pediatr Surg. 2013;48(11):2289–95.
Levitt MA, Martin CA, Olesevich M, Bauer CL, Jackson LE, Pena A. Hirschsprung disease and fecal incontinence: diagnostic and management strategies. J Pediatr Surg. 2009;44(1):271–7; discussion 277
Li N, Zhang W, Yu D, Sun X, Wei M, Weng Y, Feng J. NOTES for surgical treatment of long-segment hirschsprung’s disease: report of three cases. J Laparoendosc Adv Surg Tech A. 2013;23(12):1020–3.
Liem NT, Hau BD. Primary laparoscopic endorectal colon pull-through for Hirschsprung’s disease: early results of 61 cases. Asian J Surg. 2006;29(3):173–5.
Mattioli G, Pio L, Leonelli L, Razore B, Disma N, Montobbio G, Jasonni V, Petralia P, Pini PA. A provisional experience with robot-assisted Soave procedure for older children with Hirschsprung disease: Back to the future? J Laparoendosc Adv Surg Tech A. 2017;27(5):546–9.
Miller SS. Laparoscopic operations in paediatric surgery. Br J Surg. 1992;79(10):986–7.
Miyano G, Ochi T, Lane GJ, Okazaki T, Yamataka A. Factors affected by surgical technique when treating total colonic aganglionosis: laparoscopy-assisted versus open surgery. Pediatr Surg Int. 2013;29(4):349–52.
Muensterer OJ, Chong A, Hansen EN, Georgeson KE. Single-incision laparoscopic endorectal pull-through (SILEP) for hirschsprung disease. J Gastrointest Surg. 2010;14(12):1950–4.
Nah SA, de Coppi P, Kiely EM, Curry JI, Drake DP, Cross K, Spitz L, Eaton S, Pierro A. Duhamel pull-through for Hirschsprung disease: a comparison of open and laparoscopic techniques. J Pediatr Surg. 2012;47(2):308–12.
Oancea M, Vatra L, Kadar A, Copaescu C. Laparoscopic approach for rectosigmoidian resection in children. Chirurgia (Bucur). 2014;109(1):117–22.
Pena A, Elicevik M, Levitt MA. Reoperations in Hirschsprung disease. J Pediatr Surg. 2007;42(6):1008–13; discussion 1013–1014
Ram AD, Scholfield DW, Pimpalwar A. Novel technique of Mapping Biopsies during laparoscopic assisted transanal Soave endorectal pull-through surgery for Hirschsprung’s disease’s. Ann R Coll Surg Engl. 2017;99(6):504.
Rove KO, Edney JC, Brockel MA. Enhanced recovery after surgery in children: Promising, evidence-based multidisciplinary care. Paediatr Anaesth. 2018;28(6):482–92.
Shah AA, Shah AV. Staged laparoscopic-assisted pull-through for Hirschsprung’s disease. J Pediatr Surg. 2003;38(11):1667–9.
Short HL, Heiss KF, Burch K, Travers C, Edney J, Venable C, Raval MV. Implementation of an enhanced recovery protocol in pediatric colorectal surgery. J Pediatr Surg. 2018;53(4):688–92.
Smith BM, Steiner RB, Lobe TE. Laparoscopic Duhamel pullthrough procedure for Hirschsprung’s disease in childhood. J Laparoendosc Surg. 1994;4(4):273–6.
Teitelbaum DH, Coran AG. Primary pull-through for Hirschsprung’s disease. Semin Neonatol. 2003;8(3):233–41.
Thomson D, Allin B, Long AM, Bradnock T, Walker G, Knight M. Laparoscopic assistance for primary transanal pull-through in Hirschsprung’s disease: a systematic review and meta-analysis. BMJ Open. 2015;5(3):e006063.
Tomuschat C, Zimmer J, Puri P. Laparoscopic-assisted pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int. 2016;32(8):751–7.
Urushihara N, Fukumoto K, Fukuzawa H, Sugiyama A, Watanabe K, Mitsunaga M, Miyake H, Kusafuka J, Aoba T. Outcome of laparoscopic modified Duhamel procedure with Z-shaped anastomosis for Hirschsprung’s disease. Surg Endosc. 2012;26(5):1325–31.
Vahdad MR, Foroutan A, Najafi SM, Cernaianu G, Trobs RB, Banani SA, Foroutan HR. Totally transanal LESS pull-through colectomy: a novel approach for avoiding abdominal wall incision in children with long-segment intestinal aganglionosis. J Laparoendosc Adv Surg Tech A. 2013;23(3):276–80.
van de Ven TJ, Sloots CE, Wijnen MH, Rassouli R, van Rooij I, Wijnen RM, de Blaauw I. Transanal endorectal pull-through for classic segment Hirschsprung’s disease: with or without laparoscopic mobilization of the rectosigmoid? J Pediatr Surg. 2013;48(9):1914–8.
Wang G, Yuan J, Zhou X, Qi B, Teitelbaum DH. A modified operation for Hirschsprung’s disease: Posterior longitudinal anorectal split with a "heart-shaped" anastomosis. Pediatr Surg Int. 1996;11(4):243–5.
Wulkan ML, Georgeson KE. Primary laparoscopic endorectal pull-through for Hirschsprung’s disease in infants and children. Semin Laparosc Surg. 1998;5(1):9–13.
Xia X, Li N, Wei J, Zhang W, Yu D, Zhu T, Feng J. Single-incision laparoscopic versus conventional laparoscopic surgery for Hirschsprung’s disease: a comparison of medium-term outcomes. J Pediatr Surg. 2016a;51(3):440–3.
Xia X, Li N, Wei J, Zhang W, Yu D, Zhu T, Feng J. Laparoscopy-assisted versus transabdominal reoperation in Hirschprung’s disease for residual aganglionosis and transitional zone pathology after transanal pull-through. J Pediatr Surg. 2016b;51(4):577–81.
Zhao B, Liu T, Li Q. Comparison of the efficacy and safety of laparoscopic-assisted operations and open operations for Hirschsprung’s disease: evidence from a meta-analysis. Int J Clin Exp Med. 2015;8(8):12963–9.
Zhu T, Feng J, Zhang W, Wei M, Yu D, Zhang X, Yu K, Kuang H. Subtotal colectomy with a single-incision laparoscopic surgery technique in children with long-segment Hirschsprung disease and allied disorders. Pediatr Surg Int. 2013;29(2):197–201.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
24.1 Electronic Supplementary Material
Video 24.1
Laparoscopic heart-shaped anastomosis for Hirschsprung (WMV 574489 kb)
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Feng, Jx., Li, T., Li, N. (2019). Laparoscopically Assisted Pull-Through Operation for Hirschsprung’s Disease. In: Puri, P. (eds) Hirschsprung's Disease and Allied Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-15647-3_24
Download citation
DOI: https://doi.org/10.1007/978-3-030-15647-3_24
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-15646-6
Online ISBN: 978-3-030-15647-3
eBook Packages: MedicineMedicine (R0)