Laparoscopic histological mapping for the determination of the length of aganglionic segment in children with Hirschsprung disease

BACKGROUND Modern approach to the surgical treatment of Hirschsprung's disease (HD) consists in earliest possible repair and reduction number interventions. Primary one-stage transanal endorectal pull-through (TEPT) technique requires preoperative determination length aganglionic segment. The efficacy standard method - contrast enema is questionable patients with a poorly defined transitional zone. OBJECTIVES To present proposed laparoscopic for management pathway HD, whom segment was not possible. MATERIAL AND METHODS A retrospective analysis diagnostic therapeutic employed 14 patients, from 2 weeks 55 months age, diagnosed treated between January 2013 May 2020. Laparoscopic histological mapping performed use 3 ports 3-5 mm diameter. RESULTS In all allowed mode treatment. Four children determined short-segment underwent TEPT, while temporary colostomy formation using Duhamel-Martin-Ikeda method. Five long-segment HD laparoscopic-assisted TEPT. One patient double-barrel definitive surgery later an initial diagnosis established current pathway, pathology excluded based on results repeat rectal suction biopsy. No complications related procedure were identified. CONCLUSIONS effective HD. doubtful cases, it can be preferred option establishing final