Advances in minimally invasive neonatal colorectal surgery

Abstract

Over the last two decades, advances in laparoscopic surgery and minimally invasive techniques have transformed the operative management of neonatal colorectal surgery for conditions such as anorectal malformations (ARMs) and Hirschsprung’s disease. Evolution of surgical care has mainly occurred due to the use of laparoscopy, as opposed to a laparotomy, for intra-abdominal procedures and the development of trans-anal techniques. This review describes these advances and outlines the main minimally invasive techniques currently used for management of ARMs and Hirschsprung’s disease. There does still remain significant variation in the procedures used and this review aims to report the current literature comparing techniques with an emphasis on the short- and long-term clinical outcomes.

Outcomes of Primary versus Multiple-Staged Repair in Hirschsprung's Disease in England

“…6 Surgeons' preference for primary versus multiplestaged repair is often based on training received, level of experience, and attitude to adopt new surgical techniques. 7,8 It is unknown if a primary repair can protect the neonates from unnecessary multiple operations, higher complication rate, or longer hospital stay. There is a lack of benchmark data in neonatal colorectal surgery on 1-year postoperative outcomes and volume-outcome relationship among specialist pediatric surgical centers (SPSC).…”