Laparoscopic Modified Duhamel Procedure

  • Naoto UrushiharaEmail author


Our laparoscopic modified Duhamel procedure with a Z-shaped anastomosis is presented along with some technical points. Between 2001 and 2016, a total of 51 children with Hirschsprung’s disease (HD) underwent a laparoscopic modified Duhamel procedure. The frequency of defecation decreased gradually after surgery, and more than half of the patients experienced episodes of constipation during the early follow-up period. However, the need for medication to treat constipation decreased as the children grew older. All patients over 4 years of age, excluding patients with trisomy 21, achieved normal defecation. No patients, other than those with trisomy 21, experienced fecal and/or urinary incontinence. The laparoscopic modified Duhamel procedure provided satisfactory long-term results.


Hirschsprung’s disease Laparoscopy Duhamel procedure Z-shaped anastomosis 


  1. 1.
    Duhamel B. Une nouvelle opération pour le mégacôlon congénital: L’abaissement rétro-rectal et trans-anal du colon et son application possible au traitement de quelques autres malformations. Presse Med. 1956;64:2249–50.PubMedGoogle Scholar
  2. 2.
    Ikeda K. New techniques in the surgical treatment of Hirschsprung’s disease. Surgery. 1967;61:503–8.PubMedGoogle Scholar
  3. 3.
    Ieiri S, Nakatsuji T, Akiyoshi J, Higashi M, Hashizume M, Suita S, et al. Long-term outcomes and the quality of life of Hirschsprung disease in adolescents who have reached 18 years or older—a 47-year single institute experience. J Pediatr Surg. 2010;45:2398–402.CrossRefPubMedGoogle Scholar
  4. 4.
    Smith BM, Steiner RB, Lobe TE. Laparoscopic Duhamel pullthrough procedure for Hirschsprung’s disease in childhood. J Laparoendosc Surg. 1994;4:273–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Bax NMA, van der Zee DC. Laparoscopic removal of aganglionic bowel using the Duhamel-Martin method in 5 consecutive infants. Pediatr Surg Int. 1995;10:226–8.CrossRefGoogle Scholar
  6. 6.
    de Lagausie P, Bruneau B, Besnard M, Jaby O, Aigrain Y. Definitive treatment of Hirschsprung’s disease with a laparoscopic Duhamel pull-through procedure in childhood. Surg Laparosc Endosc. 1998;8:55–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Ghirardo V, Betalli P, Mognato G, Gamba P. Laparotomic versus laparoscopic Duhamel pull-through for Hirschsprung disease in infants and children. J Laparoendosc Adv Surg Tech. 2007;17:119–23.CrossRefGoogle Scholar
  8. 8.
    Urushihara N, Fukumoto K, Fukuzawa H, Sugiyama A, Watanabe K, Mitsunaga M, et al. Long-term outcome of modified Duhamel procedure with Z-shaped anastomosis for Hirschsprung’s disease (in Japanese with English abstract). J Jpn Soc Pediatr Surg. 2011;47:1004–9.Google Scholar
  9. 9.
    Urushihara N, Fukumoto K, Fukuzawa H, Sugiyama A, Mitsunaga M, Watanabe K, et al. Outcome of laparoscopic modified Duhamel procedure with Z-shaped anastomosis for Hirschsprung’s disease. Surg Endosc. 2012;26:1325–31.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryShizuoka Children’s HospitalShizuokaJapan

Personalised recommendations