A Provisional Experience with Robot-Assisted Soave Procedure for Older Children with Hirschsprung Disease: Back to the Future?

Girolamo Mattioli, Luca Pio, Lorenzo Leonelli, Barbara Razore, Nicola Disma, Giovanni Montobbio, Vincenzo Jasonni, Paolo Petralia, Alessio Pini Prato

Research output: Contribution to journalArticle

Abstract

Hirschsprung disease is a congenital disease characterized by intestinal aganglionosis of various extents. Most patients are younger than 1 year of age. Though, a minority of cases can be older or even adult. Older the patient the more difficult and prolonged is the endorectal dissection required for the pull-through procedure. Longer surgery leads to longer anal dilatation and trauma with subsequent higher likelihood of continence impairment. The article aims at describing the first case series of robot-assisted Soave procedure, which was adopted as an alternative minimally invasive approach to older patients with Hirschsprung disease. The technical principles are represented by intraoperative seromuscolar leveling biopsies, intracorporeal endorectal cranial dissection, and endorectal pull-through with colo-anal anastomosis. The authors report three procedures that were carried on without complication with a limited requirement for anal dilatation and trauma, given the reduced need for endorectal caudal dissection. The results demonstrate the feasibility of the proposed approach. The robotic approach should be considered as an alternative minimally invasive approach for older children or adults with Hirschsprung disease.

Original languageEnglish
Pages (from-to)546-549
Number of pages4
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques - Part A
Volume27
Issue number5
DOIs
Publication statusPublished - May 2017

Keywords

  • Adolescent
  • Anal Canal
  • Anastomosis, Surgical
  • Child, Preschool
  • Colon
  • Digestive System Surgical Procedures
  • Dilatation
  • Dissection
  • Female
  • Hirschsprung Disease
  • Humans
  • Infant
  • Male
  • Robotic Surgical Procedures
  • Journal Article

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