Journal of Indian Association of Pediatric Surgeons
Journal of Indian Association of Pediatric Surgeons
                                                   Official journal of the Indian Association of Pediatric Surgeons                           
Year : 2009  |  Volume : 14  |  Issue : 4  |  Page : 210--214

Laparoscopic assisted anorectal pull through: Reformed techniques


Karthik S Bhandary, V Kumaran, G Rajamani, S Kannan, N Venkatesa Mohan, R Rangarajan, V Muthulingam 
 Department of Pediatric Surgery, Coimbatore Medical College Hospital, Coimbatore, India

Correspondence Address:
V Kumaran
100, Rajaji Road, Ram Nagar, Coimbatore
India

Aim: To assess the modifications in the technique of laparoscopic assisted anorectal pull through (LAARP) practiced at our institute and analyze the post operative outcome and associated complications. Materials and Methods: A retrospective study from January 2001 to May 2009 analyzing LAARP for high anorectal malformations. Results: A total of 40 patients - 34 males and six females, in the age group of two months to six years were studied. Staged procedure was done in 39 patients; one child with recto vestibular fistula underwent single stage procedure. All the patients withstood surgery well. One patient required conversion due to problems in gaining enough length for the distal rectum in a patient with rectovesical fistula so colostomy was closed and re-located at a proximal splenic flexure. The complications were mucosal prolapse (six cases), anal stenosis (three), adhesive obstruction (two), distal rectal necrosis (one), and urethral diverticulum (one). The patients were followed up with clinical evaluation and continence scoring. The progress has been satisfactory and weight-gain is adequate. Conclusions: The advantages of the reformed techniques are as follows: Transcutaneous bladder stitch provides excellent visualization; traction over the fistula helps in dissection of the puborectalis, dividing the fistula without ligation is safe, railroading of Hegar«SQ»s dilators over the suction canula creates adequate pull through channel, saves time and makes procedure simpler with reproducible comparable reports.


How to cite this article:
Bhandary KS, Kumaran V, Rajamani G, Kannan S, Mohan N V, Rangarajan R, Muthulingam V. Laparoscopic assisted anorectal pull through: Reformed techniques.J Indian Assoc Pediatr Surg 2009;14:210-214


How to cite this URL:
Bhandary KS, Kumaran V, Rajamani G, Kannan S, Mohan N V, Rangarajan R, Muthulingam V. Laparoscopic assisted anorectal pull through: Reformed techniques. J Indian Assoc Pediatr Surg [serial online] 2009 [cited 2021 Apr 21 ];14:210-214
Available from: https://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=210;epage=214;aulast=Bhandary;type=0