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Laparoscopic Approach to Anorectal Malformations

  • Alejandra Vilanova-SánchezEmail author
  • Richard J. Wood
  • Rebecca M. Rentea
  • Marc A. Levitt
Chapter

Abstract

Anorectal malformations (ARM) are relatively common in children, affecting 1/5000 live births. Since the description of the posterior sagittal anorectoplasty (PSARP), the rectum is most often easily reachable from a posterior sagittal approach [1]. However, there are some malformations in which the rectum is located high in the pelvis and can benefit from a combined abdominal and perineal approach [2]. It is important to understand that if the fistula is low in the pelvis, below the peritoneal reflection (low rectoprostatic or rectobulbar or low rectum without a fistula), it may be more difficult to mobilize the very distal rectum away from the urinary/gynecologic tract utilizing an abdominal approach. Inadequate ligation of the fistula results in a retained remnant of the original fistula (ROOF) [3].

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alejandra Vilanova-Sánchez
    • 1
    Email author
  • Richard J. Wood
    • 2
  • Rebecca M. Rentea
    • 2
  • Marc A. Levitt
    • 2
  1. 1.Pediatric Surgery, Colorectal UnitUniversity Hospital La PazMadridSpain
  2. 2.Center for Colorectal and Pelvic ReconstructionNationwide Children’s HospitalColumbusUSA

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