Primary laparoscopic endorectal pull-through for Hirschsprung's disease in infants and children.

Colon pull-through for Hirschsprung's disease has classically been performed in multiple stages. Open primary pull-through procedures offer the advantages of shorter overall hospital stay, decreased morbidity, and earlier intestinal continuity, and colostomy is avoided. This article describes the techniques used and results obtained in 24 consecutive patients who had a laparoscopic primary endorectal pull-through for Hirschsprung's disease. The patients ranged in age from a few days to 6 years. Operative times ranged from 1-(1/2) hours to 3-(1/2) hours. Perioperative complications were relatively minor. None of the patients had clinical enterocolitis after primary laparoscopic pull-through, and there were no anastomotic strictures. Average postoperative length of stay was 3-(1/2) days. Primary laparoscopic endorectal pull-through is a safe and effective alternative to open primary or multistage pull-through procedures.