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Laparoscopic-Assisted Pull-Through for Hirschsprung’s Disease

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The SAGES Manual of Pediatric Minimally Invasive Surgery

Abstract

Hirschsprung’s disease (congenital megacolon) is a congenital disorder of the intestine. It is caused by incomplete migration of neural crest cells destined to become the nervous system of the distal intestine. The resultant aganglionic bowel is unable to relax, thus causing a functional obstruction. The consequences of this disease can be severe and even life threatening. Fortunately, advancements in surgical techniques and perioperative care have significantly reduced mortality rates. Furthermore, minimally invasive surgical approaches for uncomplicated cases are becoming increasingly common. This chapter provides a concise overview of Hirschsprung’s disease, including etiology, genetic associations, diagnostic workup, and treatment. The core surgical principles and procedures that were originally described for Hirschsprung’s disease will be briefly summarized. We then describe a minimally invasive surgical technique being used today to treat short-segment disease, the laparoscopic-assisted transanal pull-through. The chapter concludes with a review of the main complications and long-term issues.

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Author information

Authors and Affiliations

  1. General Surgery, Allegheny General Hospital, Pittsburgh, PA, USA

    Richard Cheek

  2. School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15261, USA

    Lauren Salesi

  3. Division of Pediatric General and Thoracic Surgery, Children’s Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, One Children’s Hospital Drive, 4401 Penn Avenue, Faculty Pavilion 7136, Pittsburgh, PA, 15215, USA

    Stefan Scholz

Authors
  1. Richard Cheek
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  2. Lauren Salesi
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  3. Stefan Scholz
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Corresponding author

Correspondence to Stefan Scholz .

Editor information

Editors and Affiliations

  1. Division of Pediatric Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA

    Danielle S. Walsh

  2. Northeast Ohio Medical College Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Todd A. Ponsky

  3. Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Nicholas E. Bruns

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Cheek, R., Salesi, L., Scholz, S. (2017). Laparoscopic-Assisted Pull-Through for Hirschsprung’s Disease. In: Walsh, D., Ponsky, T., Bruns, N. (eds) The SAGES Manual of Pediatric Minimally Invasive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43642-5_36

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  • DOI: https://doi.org/10.1007/978-3-319-43642-5_36

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43640-1

  • Online ISBN: 978-3-319-43642-5

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