Primary Laparoscopic Pull-through Research Articles

Laparoscopic pull through for Hirschsprung′s disease in infants

<b>Purpose</b>: To report personal experience with Primary Laparoscopic Pullthrough Procedure (PLPP) in infants with Hirschsprung's Disease (H.D.).<br><b>Materials and Methods: </b> Sixty four PLPP were performed by the author. In addition, 17 assisted LPP were done but not reported herein. The patients' personal and anatomic data were typical for babies with H.D.<br><b>Results: </b> Average age at operation was seven weeks (range 1-28 weeks). Operative time for PLPP averaged 140 minutes. Two babies required conversion to a standard laparotomy for anatomic reasons (long segment). Average blood loss was <5 ml. No intraoperative nor immediate post operative complications were seen. Hospitalization was short (2-3 days). Two had mild diarrhea episodes which improved without hospitalization. Another child developed a severe problem with enterocolitis 3½ years following the operation. In general, stool habits fell within the normal range for those > 4 years of age.<br><b>Conclusion: </b> PLPP is an effective, problem free approach for treating neonatal H.D. It has replaced the standard two stage open procedure in babies with uncomplicated presentation.<br>

The Status of Primary Laparoscopic Pullthrough Procedure (PLPT) in Neonates with Hirschsprung's Disease

Pediatric Endosurgery & Innovative TechniquesVol. 2, No. 4 The Status of Primary Laparoscopic Pullthrough Procedure (PLPT) in Neonates with Hirschsprung's DiseaseJUDA Z. JONAJUDA Z. JONASearch for more papers by this authorPublished Online:15 Mar 2009https://doi.org/10.1089/pei.1998.2.177AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetails Volume 2Issue 4Jan 1998 To cite this article:JUDA Z. JONA.The Status of Primary Laparoscopic Pullthrough Procedure (PLPT) in Neonates with Hirschsprung's Disease.Pediatric Endosurgery & Innovative Techniques.Jan 1998.177-180.http://doi.org/10.1089/pei.1998.2.177Published in Volume: 2 Issue 4: March 15, 2009PDF download

Literature Reviews: Pediatric Surgery: Primary Laparoscopic Pull-Through for Hirschsprung's Disease in Infants and Children

Literature Reviews: Pediatric Surgery: Primary Laparoscopic Pull-Through for Hirschsprung's Disease in Infants and Children

Primary laparoscopic pull-through for Hirschsprung's disease in infants and children

Between November 1993 and September 1994, 12 primary laparoscopic colon pull-through procedures were performed in infants and children. The patients' ages ranged from 3 days to 6 years. The primary diagnosis in all 12 patients was Hirschsprung's disease. All children had their operations without construction of preoperative or postoperative colostomy. Three 5-mm abdominal wall ports were used for access to the peritoneal cavity. The sigmoid colon and proximal rectum were mobilized laparoscopically. A submucosal sleeve was developed transanally to meet the dissection from above. The colon was then pulled down in continuity, divided above the transition zone, and secured to the anal mucosa 5 to 10 mm above the pectinate line. Mean postoperative stay was 4 days. Laparoscopic visualization provides clear delineation of pelvic structures even in small infants. Laparoscopic pull-through requires no more time than similar open procedures, averaging just over 2 hours. The morbidities associated with colostomy formation and closure and the inconvenience of colostomy care are avoided with a one-stage technique. These benefits combined with the advantages of minimally invasive surgery make primary laparoscopic pull-through a potential advance in the surgical treatment of Hirschsprung's disease.