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Redo transanal pull-through for Hirschsprung's disease
We present a case of a 3-year-old boy with a history of Hirschsprung’s Disease. He had been diagnosed at the age of two, and at that time underwent a laparoscopic-assisted Soave pull-through. He initially did well, but after a few months, had recurrent severe constipation with fecal impaction as well as an episode of enterocolitis. A contrast enema showed a dilated distal pull-through segment with normal-caliber sigmoid colon proximally, and an EUA found a preserved dentate line circumferentially with a stricture at the previous anastomosis. A biopsy was performed two centimeters proximal to the anastomosis and pathology was consistent with transition zone bowel with hypertrophic nerves and only occasional ganglion cells. We decided to do a redo transanal pull-through to remove the aganglionated and dilated segment of colon.
A Peña, M Levitt, A Bischoff, B Dickie
Surgical intervention
7 years ago
3585 views
50 likes
0 comments
05:14
Redo transanal pull-through for Hirschsprung's disease
We present a case of a 3-year-old boy with a history of Hirschsprung’s Disease. He had been diagnosed at the age of two, and at that time underwent a laparoscopic-assisted Soave pull-through. He initially did well, but after a few months, had recurrent severe constipation with fecal impaction as well as an episode of enterocolitis. A contrast enema showed a dilated distal pull-through segment with normal-caliber sigmoid colon proximally, and an EUA found a preserved dentate line circumferentially with a stricture at the previous anastomosis. A biopsy was performed two centimeters proximal to the anastomosis and pathology was consistent with transition zone bowel with hypertrophic nerves and only occasional ganglion cells. We decided to do a redo transanal pull-through to remove the aganglionated and dilated segment of colon.
Laparoscopy-assisted treatment of Hirschsprung's disease: Duhamel method
The description of the laparoscopy-assisted treatment of Hirschsprung's disease: Duhamel method covers all aspects of the surgical procedure used for the management of rectosigmoid Hirschsprung's disease.
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: laparoscopic exploration, laparoscopic rectal dissection, laparoscopic sigmoid colon dissection, transection of rectum, retrorectal pull-through, anastomosis, rectal closure.
Consequently, this operating technique is well standardized for the management of this condition.
N Bax, DC Van der Zee
Operative technique
16 years ago
2622 views
95 likes
0 comments
Laparoscopy-assisted treatment of Hirschsprung's disease: Duhamel method
The description of the laparoscopy-assisted treatment of Hirschsprung's disease: Duhamel method covers all aspects of the surgical procedure used for the management of rectosigmoid Hirschsprung's disease.
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: laparoscopic exploration, laparoscopic rectal dissection, laparoscopic sigmoid colon dissection, transection of rectum, retrorectal pull-through, anastomosis, rectal closure.
Consequently, this operating technique is well standardized for the management of this condition.