The use of the abdominal extramucosal dissection of the rectal pouch was first proposed by Romualdi at the Roman Society of Surgery on 15 May 1955. The technique was first published in 1960 . During the next few years, Rehbein  and Kiesewetter and Turner  also popularized this operation. In 1957, Soave started using Romualdi's procedure for the treatment of anorectal malformations with urethral fistula. Since his initial experience with Romualdi's technique, he thought that this principle could be applied for the treatment of Hirschsprung's disease (HSCR). So, in 1961, he performed his first operation on a 2-year-old boy with the classic form of HSCR.
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