Laparoscopic Primary Endorectal Pull-through Procedure (Boley's) for Hirschsprung's Disease

ABSTRACT

Advances in instrumentation and technique now make laparoscopic correction of some congenital anomalies possible. Author reports a 6-day-old boy with Hirschsprung's disease successfully treated by a laparoscopic endorectal pull-through procedure. The technique and its potential role in the treatment of Hirschsprung's disease are described. One camera port and three working ports were used for access to the peritoneal cavity. The descending and sigmoid colons 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 about 10 mm above the pectinate line. Author concludes that the laparoscopic endorectal pull-through procedure could be performed in safe.