Laparoscopic pull through for Hirschsprung's disease in infants

Purpose : To report personal experience with Primary Laparoscopic Pullthrough Procedure (PLPP) in infants with Hirschsprung′s Disease (H.D.).
Materials and Methods: Sixty four PLPP were performed by the author. In addition, 17 assisted LPP were done but not reported herein. The patients′ personal and anatomic data were typical for babies with H.D.
Results: Average age at operation was seven weeks (range 1-28 weeks). Operative time for PLPP averaged 140 minutes. Two babies required conversion to a standard laparotomy for anatomic reasons (long segment). Average blood loss was <5 ml. No intraoperative nor immediate post operative complications were seen. Hospitalization was short (2-3 days). Two had mild diarrhea episodes which improved without hospitalization. Another child developed a severe problem with enterocolitis 3½ years following the operation. In general, stool habits fell within the normal range for those > 4 years of age.
Conclusion: PLPP is an effective, problem free approach for treating neonatal H.D. It has replaced the standard two stage open procedure in babies with uncomplicated presentation.