Laparoscopic Duhamel procedure. Management of 30 cases.
BACKGROUND
Between February 1995 and June 1998, 30 laparoscopic Duhamel pull-through procedures were performed in our department.


METHODS
Our main aim was to prove the feasibility of the laparoscopic abdominal Duhamel procedure for different localizations of Hirschsprung disease. We used one camera port and three working ports. The sigmoid colon and posterior rectum were mobilized laparoscopically. A standard posterior colo-anal anastomosis was fashioned and a stapler was used for the anterior anastomosis. The top of the rectum was then closed by endo stapler under laparoscopic vision.


RESULTS
Thirty patients underwent laparoscopic surgery for this procedure. Three laparoscopic procedures were converted because of technical difficulties. The operative time was 100-330 mn. Oral feeding was started at a mean postoperative time of 2.5 days. Mean postoperative hospitalization was 9 days. Early postoperative complications included 1 anastomotic leak, 1 retrorectal abscess, 2 urinary infections, and 1 evisceration (after conversion). No enterocolitis or enterocolitis-like symptoms were noted. All patients now have daily spontaneous bowel movements.


CONCLUSIONS
The laparoscopic Duhamel procedure can be performed safely, giving good results.
de Lagausie
P
P
Department of Pediatric Surgery, Hôpital Robert Debré, 48, boulevard Sérurier, 75019 Paris, France.
Berrebi
D
D
Geib
G
G
Sebag
G
G
Aigrain
Y
Y
D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012007:Rectum / Q000601:surgery*; D017792:Surgical Stapling