Laparoscopic repair of anorectal malformations at the Red Cross War Memorial Children's Hospital: taking stock

Survey on the management of anorectal malformations (ARM) in European pediatric surgical centers of excellence

“…Correspondingly, minimally invasive surgery has also influenced the surgical treatment of ARM [28][29][30][31][32][33][34]. LAARP was proposed especially for ''high'' types of ARM such as rectobladderneck and rectoprostatic fistulas [31] in which the rectum is not reachable posterior-sagittally.…”

Advances in minimally invasive neonatal colorectal surgery

“…A submucosal dissection plane to create a mucosal tube of the distal rectum has been advocated as this facilitates easier ligation, further limiting the amount of fistula tissue left attached to the urethra[9]. Initial reports described clip or endoloop ligation of the fistula but later studies have shown that simple sharp ligation flush with the bladder is the best technique[10,11]. …”

“…The laparoscopic Peña electrostimulator has been used to identify accurately the centre of the muscle complex in the perineum[10,12]. This can be particularly useful in cases of immature and unclear levator muscles[3,13].…”

“…Ischaemia of the pull-through and tension on the anastomosis are causes of stenosis but it can also result from non-compliance with the postoperative dilatation regimes[10]. …”

Developments in pediatric colorectal pathologies

“…Rektumdan presakral fasyaya dikiş konulması buna çözüm olabilir denilmesine karşın yarar sağlamadığını düşünenler de mevcuttur (16) . Bunun yanı sıra anal darlık, posterior üretrada divertikül, bağırsak tıkanıklıkları, karın boşluğuna kaçak, kesi yeri enfeksiyonu ve ayrılması, üriner retansiyon, yineleyen fistül, port yerinde fıtık gelişimi, rektal mislokasyon, karın boşluğuna idrar kaçağı, pelvik sepsis, üretral hasarlanma, retraksiyon, üretral mukosel, üreterin kesilmesi ve vas deferensin hasarlanması rapor edilmiştir (14,17) .…”