title: Robotic Swenson pull-through for Hirschsprung's disease in infants.
abstract: It has been demonstrated that infants with Hirschsprung's disease can be treated with a one-stage laparoscopic resection and coloanal pull-through. However, the feasibility and benefits of performing this operation using robotic technology have not yet been evaluated. We reviewed our  experience with 12 infants diagnosed with Hirschsprung's disease and treated with laparoscopic-robotic assisted colonic resection with proctectomy and pull-through using the da Vinci robotic system. Patients were treated at a mean age/weight of 16 weeks/5.5 kg. The average operative time for  the robotic procedure was 230 minutes, and average length of stay was 3 days. At discharge, all patients were having regular bowel movements and tolerating a completely oral diet. All patients received early postoperative anorectal dilation and six patients required dilations for an average  of 12 weeks after surgery for management of minor rectal strictures. Only two patients developed postoperative enterocolitis with a mean follow-up of 36 months. A robotic approach for performing a Swenson-type resection and pull-through procedure can be performed safely and successfully in  young infants. Robotic technology provided superior dexterity and visualization, essential in performing a more complete rectal dissection, thus allowing for a complete proctectomy and eliminating the risk of leaving a segment of aganglionic rectum behind.
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Medical University of South Carolina, Charleston, South Carolina, USA. hebra@musc.edu
authors.forename: André
authors.initials: A
authors.lastname: Hebra
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Smith
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Lesher
mesh_terms: D003106:Colon / Q000601:surgery*; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D012371:Robotics