Laparoscopic Swenson's Pull-Through for Hirschsprung's Disease

The purpose of this study was to analyze the initial results of laparoscopic Swenson's pull-through in the treatment of Hirschsprung's disease. A three-trocar technique following the principles of the original Swenson's procedure was used for the laparoscopic pull-through. Patients were identified retrospectively and followed up prospectively in the outpatient clinic. Demographic, preoperative, operative, and postoperative data were collected and analyzed. Eleven children underwent a one-stage pull-through with preoperative irrigations. Three children underwent a two-stage procedure with an initial defunctioning colostomy. The average age at surgery was 9.4 months (range 3.2–45.7 months) with a mean operative weight of 8.8 kg (range 5.8–18.4 kg). The mean operative time was 237 min (range 180–305 min). The first oral intake occurred at a mean of 1.5 days (range 0–4 days), and the first bowel movement occurred at 1.6 days (range 1–5 days). The average postoperative stay was 4.4 days (range 3–6 days). In the outpatient follow-up, all patients were gaining weight and stooling regularly. There have been no major complications in up to 27 months of follow-up. With these encouraging early results, laparoscopic Swenson's pull-through has become the authors' procedure of choice in the surgical management of Hirschprung's disease.