Intraluminal manipulator-assisted laparoscopic surgery for Hirschsprung disease

Toshihiko Watanabe, Masaharu Mori, Takahiro Shimizu, Yuki Yamamoto, Eri Tei, Hitoshi Hirakawa, Michinobu Ohno, Kazunori Tahara, Kotaro Tomonaga, Katsuhiro Ogawa, Toshiko Takezoe, Yasushi Fuchimoto, Akihiro Fujino, Yutaka Kanamori

Research output: Contribution to journalArticlepeer-review


Background: Total colonic aganglionosis (TCA) and long segment aganglionosis (LSA) are rare forms of Hirschsprung disease (HD). Laparoscopic resection of total or the longer segment of the colon has not been unestablished for these forms. Methods: We retrospectively reviewed five infants with TCA or LSA who underwent the blunt tip dissector (BD) assisted laparoscopic Soave pull-through procedure, and patients’ characteristics and procedure outcomes were analyzed. Results: One infant with TCA had Mowat–Wilson syndrome. Ileostomy for TCA and transanal catheter placement for LSA allowed full enteral feeding with good weight gain before operation. The BD manipulator used in the laparoscopic surgery was simple to use and powerful enough to create tension, expand operating space, and improve access to specific parts of the mesentery or pelvis. No intraoperative complications such as perforation or bleeding were noted; thus, the operation was completed uneventfully, without conversion to open surgery in all cases. All the patients had excellent cosmetic results, without late complications. Conclusions: The BD manipulator is safe and effective to facilitate laparoscopy-assisted Soave pull-through procedure in children with TCA and LSA. This approach may be applied to the other pediatric diseases, which require resection of the longer segment of the colon.

Original languageEnglish
Article number101606
JournalJournal of Pediatric Surgery Case Reports
Publication statusPublished - 2020 Oct


  • Blunt tip dissector
  • Children
  • Colon manipulator
  • Hirschsprung disease
  • Laparoscopy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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