Transanal Pull-Through With or Without Laparoscopic Assistance for Rectosigmoid Hirschsprung’s Disease

Abstract

To ensure good postoperative bowel function (POBF) following transanal pull-through (TAPT) for Hirschsprung’s disease (HD), transanal dissection should commence just proximal to the anorectal line (ARL), leaving the ARL intact and preserving the anal transitional zone (ATZ). Because the ARL is a readily identifiable landmark, transanal dissection will thus become standardized with reliable and reproducible results. In addition, the posterior rectal muscle cuff above the ARL should be excised completely to fully release achalasia due to an aganglionic rectum while preserving the ARL and the ATZ.