Primary Laparoscopic Pull-Through For Hirschsprung's Disease


If your infant is diagnosed with Hirschsprung�s disease and is selected for undergoing the primary laparoscopic pull- through for this disease, doing the same through the laparoscopic way of surgery is the best option. When this method of surgery is used, this can be cured in early stages and with few stages of surgical process. This offers many advantages of using less amounts of anesthesia, lesser strains during the surgery and circumvents the complications of colostomy. When this type of surgery is performed this is able to bring down much of the trauma that occurs during surgery on the peritoneal cavity.

During the conduct of the Primary laparoscopic pull-through for Hirschsprung's disease, four small abdominal ports are used for this procedure. The zone of the surgery is first identified by seromuscular biopsies that were taken out with the help of laparoscopes. This is done in stages as follows:

  • A colon pedicle to safeguard the marginal artery is done through endoscope
  • Rectal mobilization is done transanlly by using the endorectal sleeve technique
  • Anastomosis �is performed transanally above 1cm of the dentate lone

This type of surgery is becoming very popular among the infants and the average duration of the surgical procedure is around 2.5 hours. The most notable benefit of this procedure is that the child is able to pass stool within 24 hours of the surgery, and the average time of discharge from the hospital ranges from 3 to 4 days.

Hirschprung disease

This surgical method using laparoscope is able to reduce the pre-operative complications in a more efficient way and the pre- surgical management of the patient is very easy and is able to be made ready for surgery in a swifter manner. Yet another benefit of the Primary laparoscopic pull-through for Hirschsprung's disease is its less possible post- operative recovery time for the patient. As far as the surgeons are concerned it is very easy to learn the technique and it is being performed in many of the healthcare facilities with consistently good results.

Before the performance of the surgery, the patient is administered with barium enema. Those children with distal colon aganglionosis are considered to be the best candidates for the Primary laparoscopic pull-through for Hirschsprung's disease. The children afflicted with severe enterocolitis or those with poor general health are usually not considered good for this procedure. As a way of preparing of the patient for the Primary laparoscopic pull-through for Hirschsprung's disease the anti- biotics that are used in the pre-surgery are given as usual. The Pneumoperitoneum was secured using a Varess needle pierced in through the umbilicus.

The trocar site for the scope is placed below the edge of the liver cavity and at the side of the falciform ligament. Trocars are also placed in the lower quadrant of the right side, and the upper quadrant of the abdomen on the left side. These ports are made in different sizes ranging from 4 to 5 mm in diameter as per the size of the patient.� After the surgery is over, the patients are placed on nasogastric compression for a period of 12 hours and the diet is restored after the bowel function resumes. The patient becomes ready for discharge as soon as the child tolerates oral diet.

Thus the Primary laparoscopic pull-through for Hirschsprung's disease is one of the best ways to cure this condition in young children.


For more information:

World Laparoscopy Hospital, Cyber City, DLF Phase II, Gurugram, NCR Delhi, 122 002, India
For Training: +919811416838
For Treatment: +919811912768
For General Enquiry: +91(0)124 - 2351555

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