Laparoscopic Assisted Anorectal Pull-Trough for Hirschsprung Disease in a 12 Months Old Boy

This video shows laparoscopy-assisted anorectal pull-through for HD. The first laparoscopic approach to pull-through surgery for Hirschsprung disease was described in 1995 by Georgeson. A laparoscopic biopsy is performed to identify the transition zone, followed by laparoscopic mobilization of the rectum below the peritoneal reflection and endoscopic dissection of the colon and rectum. A short mucosal dissection starting at the dentate line, similar to the Soave procedure, is also performed and the rectum is then prolapsed through the anus with the anastomosis done transanally. This procedure has been associated with shorter hospital and similar early outcomes to the open procedures. Additionally, laparoscopic approaches to the Duhamel and Swenson operations have also been described with excellent short-term results.