Role of laparoscopy in Hirschsprung disease

Elective

- Elective training at Mnsoura university children hospital

- Duration of 3 weeks from 31th of july to 18th of August 2022

- supervised by Dr. tamer Ashraf. Assistant professor of pediatric surgery, Faculty of Medecine

Mansoura university

Introduction

Hirschsprung disease is a disease of the enteric nervous system of the distal intestine resulting in functional intestinal obstrution.

Introduction

Ji Y, Tam PK, Tang CS. Roles of Enteric Neural Stem Cell Niche and Enteric Nervous System Development in Hirschsprung Disease. International Journal of Molecular Sciences. 2021 Sep 7;22(18):9659

Different Hirschsprung operations

Different Hirschsprung operations

Langer JC. Hirschsprung disease. Fundamentals of pediatric surgery. 2011:475-84.

Steps

Step 1: establishing the level of the transition zone

Step 2: Laparoscopic Colorectal Dissection

Step 3: trans-anal dissection

Step 4: Total Excision of the Posterior A- ganglionic Rectal Muscle Cuff

Step 5: pull-through and anastomosis

Laparoscopically assisted pull-through techniquue

outcomes

Outcomes and how to manage

Laparoscopy versus traditional open techniques outcome

Laparoscopy versus traditional open techniques

Take home messege

Laparoscopic assisted trans-anal pull-through is a satisfying procedure for Hirschsprung disease

take home messege

References

Ji Y, Tam PK, Tang CS. Roles of Enteric Neural Stem Cell Niche and Enteric Nervous System Development in Hirschsprung Disease. International Journal of Molecular Sciences. 2021 Sep 7;22(18):9659

Heuckeroth RO. Hirschsprung disease—integrating basic science and clinical medicine to improve outcomes. Nature Reviews Gastroenterology & Hepatology. 2018 Mar;15(3):152-67.

Yamataka A, Miyano G, Takeda M. Minimally invasive neonatal surgery: Hirschsprung disease. Clinics in Perinatology. 2017 Dec 1;44(4):851-64.

Demehri FR, Dickie BH. Reoperative techniques and management in Hirschsprung disease: a narrative review. Translational Gastroenterology and Hepatology. 2021;6.

Langer JC. Hirschsprung disease. Fundamentals of pediatric surgery. 2011:475-84.

Scholfield DW, Ram AD. Laparoscopic Duhamel procedure for Hirschsprung's disease: systematic review and meta-analysis. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2016 Jan 1;26(1):53-61.

Thomson D, Allin B, Long AM, Bradnock T, Walker G, Knight M. Laparoscopic assistance for primary transanal pull-through in Hirschsprung's disease: a systematic review and meta-analysis. BMJ open. 2015 Mar 1;5(3):e006063.

El-Sawaf MI, Drongowski RA, Chamberlain JN, Coran AG, Teitelbaum DH. Are the long-term results of the transanal pull-through equal to those of the transabdominal pullthrough? A comparison of the 2 approaches for Hirschsprung disease. Journal of pediatric surgery. 2007 Jan 1;42(1):41-7.