Abstract
Background/Purpose: The mucosectomy of the aganglionic rectal mucosa has been performed transabdominally in the Soave procedure. Recently, mucosectomy with transanal approach was reported both in the laparoscopic and the open surgical procedure. However, the operative view and working field are restricted because the dissection has to be done in the anal canal. The authors report an innovative approach, an extra-anal mucosectomy, to perform mucosectomy in the Soave procedure for Hirschspung's disease in combination with the laparoscopic-assisted prolapsing technique. Methods: Four patients underwent laparoscopic surgery for Hirschsprung's disease with extra-anal mucosectomy between 1995 and 1997. One 10-mm and 5-mm ports were used throughout the operation. The rectum was pulled out through the anal canal to create a rectal prolapse and was divided outside the anal canal. The mucosectomy was performed in the everted rectal mucosa outside the anal canal to the level of dentate line. The colon was sutured to the anal mucosa 2 mm above the dentate line. Mean operative time was 3 hours. Results: The present technique made the whole mucosectomy possible under direct observation. Conclusion: The extra-anal mucosectomy in conjunction with a laparoscopic- assisted prolapsing technique seems to be a safe and reliable modality in the surgical treatment of Hirschsprung's disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1679-1681 |
| Number of pages | 3 |
| Journal | Journal of Pediatric Surgery |
| Volume | 33 |
| Issue number | 11 |
| Publication status | Published - 1998 Nov |
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Keywords
- Extra-anal mucosectomy
- Hirschsprung's disease
- Laparoscopic surgery
- Prolapsing technique
ASJC Scopus subject areas
- Surgery
Cite this
Extra-anal mucosectomy : Laparoscopic-assisted endorectal pull-through using a prolapsing technique. / Morikawa, Yasuhide; Hoshino, Ken; Matsumura, Kiichiro; Yoshioka, Shigehiro; Yokoyama, Jotaro; Kitajima, Masaki.
In: Journal of Pediatric Surgery, Vol. 33, No. 11, 11.1998, p. 1679-1681.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Extra-anal mucosectomy
T2 - Laparoscopic-assisted endorectal pull-through using a prolapsing technique
AU - Morikawa, Yasuhide
AU - Hoshino, Ken
AU - Matsumura, Kiichiro
AU - Yoshioka, Shigehiro
AU - Yokoyama, Jotaro
AU - Kitajima, Masaki
PY - 1998/11
Y1 - 1998/11
N2 - Background/Purpose: The mucosectomy of the aganglionic rectal mucosa has been performed transabdominally in the Soave procedure. Recently, mucosectomy with transanal approach was reported both in the laparoscopic and the open surgical procedure. However, the operative view and working field are restricted because the dissection has to be done in the anal canal. The authors report an innovative approach, an extra-anal mucosectomy, to perform mucosectomy in the Soave procedure for Hirschspung's disease in combination with the laparoscopic-assisted prolapsing technique. Methods: Four patients underwent laparoscopic surgery for Hirschsprung's disease with extra-anal mucosectomy between 1995 and 1997. One 10-mm and 5-mm ports were used throughout the operation. The rectum was pulled out through the anal canal to create a rectal prolapse and was divided outside the anal canal. The mucosectomy was performed in the everted rectal mucosa outside the anal canal to the level of dentate line. The colon was sutured to the anal mucosa 2 mm above the dentate line. Mean operative time was 3 hours. Results: The present technique made the whole mucosectomy possible under direct observation. Conclusion: The extra-anal mucosectomy in conjunction with a laparoscopic- assisted prolapsing technique seems to be a safe and reliable modality in the surgical treatment of Hirschsprung's disease.
AB - Background/Purpose: The mucosectomy of the aganglionic rectal mucosa has been performed transabdominally in the Soave procedure. Recently, mucosectomy with transanal approach was reported both in the laparoscopic and the open surgical procedure. However, the operative view and working field are restricted because the dissection has to be done in the anal canal. The authors report an innovative approach, an extra-anal mucosectomy, to perform mucosectomy in the Soave procedure for Hirschspung's disease in combination with the laparoscopic-assisted prolapsing technique. Methods: Four patients underwent laparoscopic surgery for Hirschsprung's disease with extra-anal mucosectomy between 1995 and 1997. One 10-mm and 5-mm ports were used throughout the operation. The rectum was pulled out through the anal canal to create a rectal prolapse and was divided outside the anal canal. The mucosectomy was performed in the everted rectal mucosa outside the anal canal to the level of dentate line. The colon was sutured to the anal mucosa 2 mm above the dentate line. Mean operative time was 3 hours. Results: The present technique made the whole mucosectomy possible under direct observation. Conclusion: The extra-anal mucosectomy in conjunction with a laparoscopic- assisted prolapsing technique seems to be a safe and reliable modality in the surgical treatment of Hirschsprung's disease.
KW - Extra-anal mucosectomy
KW - Hirschsprung's disease
KW - Laparoscopic surgery
KW - Prolapsing technique
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UR - http://www.scopus.com/inward/citedby.url?scp=0031791970&partnerID=8YFLogxK
M3 - Article
C2 - 9856894
AN - SCOPUS:0031791970
VL - 33
SP - 1679
EP - 1681
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 11
ER -