The laparoscopic assisted duhamel pull through procedure for. Postoperative enterocolitis occurred in three of four long procedures done for total colonic aganglionosis. Duhamelmartin procedure for hirschsprungs disease in. A critical evaluation of the duhamel operation for hirschsprungs. Two frequently used techniques are the duhamel procedure and the. A comparative retrospective study between an open and a laparoscopic technique. Abdominalperineal resection of the aganglionic rectum and colon by the technique described by swenson 1 in 1948 is the standard operation for the definitive surgical treatment of hirschsprungs disease. Pdf duhamels procedure for adult hirschsprungs disease. Modified duhamel procedure for treatment of hirschsprungs. We compared outcome of surgery for total colon aganglionosis tca and classical type rectosigmoid hd rshd at our institute and elsewhere focusing on the laparoscopic duhamel z procedure lapdz.
Singlestage modified duhamel procedure for hirschsprung. Volume 53, issue 9, september 2018, pages 17101715. A recent british association of pediatric surgeons survey confirmed that 62% of consultants prefer duhamels technique for. Laparoscopicassisted duhamel procedure has a larger anastomosis and a.
In the duhamel technique, a section of aganglionic rectum is left. This procedure also has advantage of minimal pelvic dissection. What is the duhamel procedure for surgical treatment of. The laparoscopic assisted duhamel pull through procedure. Duhamels procedure for adult hirschsprungs disease ecommons. The duhamel procedure was first described in 1956 as a modification to the swenson procedure. Singlestage modified duhamel procedure for hirschsprungs disease. The modified duhamel procedure was associated with. Singh s, wakhlu a, ahmad i, srivastava nk 2017 the laparoscopic assisted duhamel pull through procedure for hirschsprungs disease. Duhamel versus transanal endorectal pull through terpt for the. Duhamels procedure for adult hirschsprungs disease. Pdf primary singlestage pullthrough for hirschsprungs disease. A retrospective study was performed to demonstrate that a onestage duhamelmartin procedure is feasible for hirschsprungs disease, even in neonates and infants. We present three patients with hirschsprungs disease who successfully underwent the modified duhamel procedure.
Pdf singlestage modified duhamel procedure for hirschsprungs. Department of surgery, the aga khan university hospital. This was retrospectively compared with the 25 cases of open duhamel procedures. With appropriate modifications, the duhamel operation is a very satisfactory definitive procedure for hirschsprungs disease in infancy and childhood. A retrorectal approach is used, and a significant segment of aganglionic rectum is retained. Duhamel s procedure with a diverting loop ileostomy was successfully performed. In a 2 1 2year period, 32 children with hirschsprungs disease were treated according to the method of duhamelmartin.
After clinicoradiological diagnosis of hirschsprungs disease junctional colostomy and mutltiple seromuscular biopsy was taken. Swenson emphasized that this is a difficult operation that must be performed with careful attention to detail to assure satisfactory results. To prospectively evaluate the laparoscopic assisted duhamel pull through ladpt procedure for hirschsprungs disease at our centre. In 22 of them the diagnosis had been established within the first 2 months of life. Since duhamel introduced a new operative technique for hirschsprungs disease in infants in 1956 1, 2, his procedure. Compared with other major surgical techniques for hirschsprung disease hd, such as the soave and swenson procedure, the original duhamel procedure has the benefit of less pelvic dissection and less anastomotic stricture formation, but the most common postoperative complication is fecalith formation secondary to a rectal blind pouch or remnant colorectal septum. A recent british association of pediatric surgeons survey confirmed that 62% of consultants prefer duhamel s technique for children with hirschsprungs disease 3. However, users may print, download, or email articles for individual use. The diagnosis was suspected on the basis of the typical. Pdf the laparoscopic assisted duhamel pull through procedure. Since duhamel introduced a new operative technique for hirschsprungs disease in infants in 1956 1, 2, his procedure has gained wide acceptance worldwide. After histological confirmation of diagnosis definitive surgery was done by laparoscopic assisted.
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