The Laparoscopic Assisted Duhamel Pull through Procedure for Hirschsprung’s Disease: Our Technique and Short Term Results

The Hirschsprung’s disease (HD) is characterized by absence of ganglion cells in the Myentric and Meissners plexus’ with nerve bundle hyperplasia [1,2]. The surgery for HD is changed from multistage surgery to single stage. Further, till date the superiority of either Duhamel, Swenson or soave procedure is comparable. It is unclear if one of these techniques yields significantly better general (execution and timing of procedures) or and diseasespecific outcomes. Most of the pediatric surgeons are stick to the surgical procedures of their choice [3]. In the Duhamel procedure, a section of aganglionic rectum is left in situ and anastomosed to pulled down segment of ganglionic colon (side-to-side) as a pouch reservoir. Duhamel procedure has gained popularity due to technical ease, minimal anal stretching and better visibility in entire procedure [2,3]. The author has been performing the open staged Duhamel operations for HD since 20 yrs and laparoscopic assisted Duhamel pull through (LADPT) for last 2 years. The aim of this study was to review technique and early follow-up results of LADPT and compare it with open Duhamel procedure.