LAPAROSCOPIC INTERVENTION IN HIRSCHSPRUNG DISEASE - MARTIN DUHAMEL METHOD

Abstract

Hirschsprung's disease or congenital megacolon is a developmental disorder characterized by the absence of nerve cells in the myenteric plexus in the distal colon. The specific symptoms are caused by the absence of the peristaltic movement in the affected segment. 75% of cases involve the recto-sigmoid region, and 60% of children affected have other associated congenital diseases (ophthalmological, urogenital, cardiac or central nervous system anomalies).We are presenting the case of a newborn delivered at term who develops symptoms represented by: abdominal distension, delay in the pass of meconium, food intolerance and vomiting all indicating the clinical picture of low intestinal obstruction. Following clinical examination, abdominal radiographs, contrast enema, serial biopsies of rectal and colonic wall as well as anorectal manometry the diagnosis of congenital megacolon - Hirschsprung disease is placed. The article includes a detailed description of the surgical technique used in this case: Duhamel-Martin Laparoscopic assisted method. Evolution is favorable, with no early or long term complications. The laparoscopic assisted Duhamel technique is among the first therapeutic options when it comes to addressing a newborn with Hirschsprung's disease, a technique not commonly used but with very good prognosis in the presented case.