Hirschsprung's Disease: A Case Study
The first description of the etiology and surgical approach to Hirschsprung 's disease was by Dr Ovar Swenson in 1948[1]. Swenson 's operation was difficult to carry out in early infancy also extensive dissection of the pelvis occasionally caused complications, therefore several methods including those proposed by Duhamel[2], Soave[3], and their modifications have been devised aiming at minimizing pelvic dissection, preserving the rectal wall and maintaining rectal sensation. Many problems, however, appeared due to leaving aganglionic tissues for example, fecaloma formation in the residual blind anterior rectal pouch [4] and functional obstruction of the pull through caused by the Soave cuff [5, 6]. Recently, M.A. Levitt et al. described transanal Swenson-like approach for Hirschsprung 's disease based on their experience of full thickness rectal dissection in anorectal malformation in order to avoid bad impact on fecal, urinary, and sexual function.[7] …show more content…
Autonomic nerves lie anterior to Denonviliers ' fascia, thus working within fascia propria avoid injury to autonomic pelvic nerves [8]. This study evaluates the short term outcomes of trans anal full thickness procedure for cases of rectosigmoid Hirschsprung 's disease by performing dissection tightly on the rectal wall within the fascia propria to prevent injury of pelvic nerves and other structures and avoid obstructive symptoms associated with other procedures like Soave (muscular cuff) or Duhamel (spur
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