Single-incision laparoscopic-assisted anorectoplasty using conventional instruments for children with anorectal malformations and rectourethral or rectovesical fistula

2014 ◽  
Vol 49 (11) ◽  
pp. 1689-1694 ◽  
Author(s):  
Mei Diao ◽  
Long Li ◽  
Mao Ye ◽  
Wei Cheng
Keyword(s):  
Single Incision ◽  
Anorectal Malformations ◽  
Conventional Instruments ◽  
Rectovesical Fistula ◽  
Laparoscopic Assisted

scholarly journals Suspension sutures facilitate single-incision laparoscopic-assisted rectal pull-through for Hirschsprung disease

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liem Thanh Nguyen ◽  
Anh Tho Nguyen ◽  
Quang Thanh Nguyen ◽  
Quynh Anh Tran ◽  
Hau Duc Bui ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Single Incision ◽  
Hirschsprung Disease ◽  
Conventional Instruments ◽  
Long Term Follow Up ◽  
Pull Through ◽  
Laparoscopic Assisted ◽  
Suspension Suture

Abstract Background To present a surgical technique of single-incision laparoscopic-assisted endorectal pull-through (SILEP) with suspension sutures using conventional instruments for Hirschsprung disease (HD) and its long-term follow-up outcomes. Methods The procedure began with a 1 cm transumbilical skin incision. Three separate punctures were made in the fascia with a 5 mm scope in the middle and 5 mm and 3 mm ports for working instruments on the left and right, respectively. The first suspension suture was placed to secure the sigmoid colon to the abdominal wall. A window was created through the rectal mesentery, and dissection around the rectum was carried out. The second suspension suture was performed to suspend the rectovesical peritoneal fold or the rectovaginal peritoneal fold to the abdominal wall. Dissection around the rectum was continued downward to approximately 1 cm below the peritoneal fold. Then, the operation was completed by a transanal approach. Results Forty patients underwent SILEP from March 2013 to April 2015. The median age was 2.7 months (ranging from 1 to 17 months). The mean operative time was 96 ± 23 min. No conversion to an open operation was required. The average hospitalization time was 4.5 ± 2 days. There were no intraoperative or perioperative complications. Long-term follow-up results were obtained from 38 patients. A frequency of defecation from every other day to twice a day was noted for 33 patients (86.8%) and more often for 5 patients (13.2%). Two patients had enterocolitis (5.2%). Conclusion Single-incision laparoscopic rectal pull-through with suspension sutures using conventional instruments is feasible and safe for HD with good long-term outcomes.

scholarly journals Suspension Sutures Facilitate Single Incision Laparoscopic-Assisted Rectal Pull-Through for Hirschsprung Disease

2020 ◽  
Author(s):  
Liem Thanh Nguyen ◽  
Anh Nguyen Tho ◽  
Quang Nguyen Thanh ◽  
Quynh Tran Anh ◽  
Hau Bui Duc ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Single Incision ◽  
Hirschsprung Disease ◽  
Conventional Instruments ◽  
Long Term Follow Up ◽  
Pull Through ◽  
Laparoscopic Assisted ◽  
Suspension Suture

Abstract BackgroundTo present the surgical technique and long-term follow-up outcomes of single incision laparoscopic-assisted endorectal pull-through (SILEP) with suspension sutures using conventional instruments for Hirschsprung disease. MethodsThe procedure began with a 1cm transumbilical skin incision. Three separate punctures were made onto the fascia for a 5mm scope in the middle, a 5mm and 3mm ports for working instruments on the left and right, respectively. The first suspension suture was performed to secure the sigmoid colon to the abdominal wall. A window was created through the rectal mesentery, and dissection around the rectum was carried out. The second suspension suture was performed to suspense the rectovesical peritoneal fold or the rectovaginal peritoneal fold to the abdominal wall. Dissection around the rectum was continued downward to approximately 1cm below the peritoneal fold. The operation was completed by a transanal approach. Results40 patients underwent SILEP from March 2013 to April 2015. The median age was 2.7 months (ranged from 14 days to17 months). The mean operative time was 94.7 ± 20 minutes. No conversion to open operation was required. Mean hospital stay was 4.1±1.3 days. There were no intraoperative or perioperative complications. Long term follow-up results were obtained in 38 patients. The number of defecation from 1-2 times per day was noted in 36 patients (94.7%) and from 3-4 times per day in 2 patients (5.2%). Two patients had enterocolitis (5.2%).ConclusionSingle site laparoscopic rectal pull-through with suspension sutures using conventional instruments is feasible and safe for Hirschsprung disease with good long-term outcomes.

Multicenter Study of 342 Anorectal Malformation Patients: Age, Gender, Krickenbeck Subtypes, and Associated Anomalies

2019 ◽  
Vol 30 (05) ◽  
pp. 447-451
Author(s):  
Tahmina Banu ◽  
Anwarul Karim ◽  
Maryam Ghavami Adel ◽  
Kokila Lakhoo ◽  
Tasmiah Tahera Aziz ◽  
...  
Keyword(s):  
Anorectal Malformations ◽  
Associated Anomalies ◽  
Gender Distribution ◽  
Female Ratio ◽  
Iranian Patient ◽  
Relative Incidence ◽  
Organ Systems ◽  
Rectovesical Fistula ◽  
Global Initiative ◽  
Male To Female

Abstract Introduction Published studies based on Krickenbeck classification of anorectal malformations (ARMs) are still insufficient to assess the global as well as regional relative incidence of different ARM subtypes, gender distribution, and associated anomalies. The primary purpose of this study was to provide an estimate of those in Global Initiative for Children's Surgery (GICS) research group. Materials and Methods We collected ARM data prospectively for 1 year from four institutes of different geographic locations. A total of 342 patients were included in this study (195, 126, 11, and 10 from Bangladesh, Iran, Papua New Guinea, and Oxford, United Kingdom, respectively). Results Overall male to female ratio was 1:1. The most frequent ARM subtype was perineal fistula (23.7% = 81/342). About 48.5% (166/342) patients had at least one associated anomaly. Cardiac and genitourinary systems were the most commonly affected systems, 31.6% (108/342) and 18.4% (63/342), respectively. These organ-systems were followed by anomalies of vertebral/spinal (9.9% = 34/342), musculoskeletal (4.4% = 15/342), and gastrointestinal/abdominal (3.2% = 11/342) systems. Rectovesical fistula had the highest percentage (96.4% = 27/28) of associated anomalies. About 18.1% (62/342) patients had multiple anomalies. ARMs (both isolated and with associated anomalies) occurred equally in males and females. Comparison between patients from Bangladesh and Iran showed differences in relative incidence in ARM subtypes. In addition, Iranian patient group had higher percentage of associated anomalies compared with Bangladeshi (73 vs. 35.4%). Conclusion Our study provides important insights about ARM subtypes, gender distribution and associated anomalies based on Krickenbeck classification especially from Bangladesh and Iran.

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