SpringerLink
Log in

Robotic Soave pull-through procedure for Hirschsprung’s disease in children under 12-months: long-term outcomes

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

To describe the long-term outcomes of the robotic Soave pull-through (RSPT) procedure for Hirschsprung’s disease (HSCR) in children younger than 12 months.

Methods

A prospective observational study was conducted on HSCR patients under 12 months of age who underwent RSPT at our institution between 2011 and 2020. Data regarding demographics, clinical features, technical details, operative time, hospital stay, postoperative complications, and long-term outcomes were prospectively collected.

Results

A total of 15 patients (9 male; 6 female) were included, with a median age at surgery of 4 months (interquartile range 3–6), and a mean weight of 6.8 ± 1.3 kg. Twelve patients suffered from rectosigmoid aganglionosis and three from long HSCR (extending up to the hepatic flexure). The mean total operative time was 240 ± 72 min. The median hospital stay was 3 days (interquartile range 3–4). Partial anastomosis dehiscence was observed in one patient, requiring reoperation on the 4th postoperative day. With a median follow-up of 79 months (interquartile range 45–115), no fecal incontinence or mild soiling were observed. Constipation occurred in two patients and mild enterocolitis in one case.

Conclusion

RSPT procedure for Hirschsprung’s disease in children younger than 12 months is a safe and effective procedure, with few complications and satisfactory long-term continence outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Cave J, Clarke S (2018) Paediatric robotic surgery. Ann R Coll Surg Engl 100(Suppl 7):18–21

    Article  Google Scholar 

  2. Soave F (1964) Hirschsprung’s disease: a new surgical technique. Arch Dis Child 39:116–124

    Article  CAS  Google Scholar 

  3. Rickey J, Robinson CC, Camps JI, Garcia JA (2013) Robotic-assisted Soave procedure in an 18-year-old man with adult short-segment Hirschsprung’s disease. Am Surg 79(6):E223–E225

    Article  Google Scholar 

  4. Ruiz MR, Kalfa N, Allal H (2016) Advantages of robot-assisted surgery in anorectal malformations: report of a case. J Minim Access Surg 12(2):176–178

    Article  Google Scholar 

  5. Mattioli G, Pio L, Leonelli L, Razore B, Disma N, Montobbio G et al (2017) A provisional experience with robot-assisted Soave procedure for older children with Hirschsprung disease: back to the future? J Laparoendosc Adv Surg Tech A 27(5):546–549

    Article  Google Scholar 

  6. Pini Prato A, Arnoldi R, Dusio MP, Cimorelli A, Barbetta V, Felici E, Barbieri P et al (2020) Totally robotic Soave pull-through procedure for Hirschsprung’s disease: lessons learned from 11 consecutive pediatric patients. Pediatr Surg Int 36(2):209–218

    Article  Google Scholar 

  7. Quynh TA, Hien PD, Du LQ, Long LH, Tran NTN, Hung T (2021) The follow-up of the robotic-assisted Soave procedure for Hirschsprung’s disease in children. J Robot Surg. https://doi.org/10.1007/s11701-021-01238-z

    Article  PubMed  Google Scholar 

  8. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  Google Scholar 

  9. Pini Prato A, Gentilino V, Giunta C et al (2008) Hirschsprung’s disease: 13 years’ experience in 112 patients from a single institution. Pediatr Surg Int 24:175–182

    Article  Google Scholar 

  10. Benninga MA, Faure C, Hyman PE, St James Roberts I, Schechter NL, Nurko S (2016) Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology 150:1443–1455

    Article  Google Scholar 

  11. Pastor AC, Osman F, Teitelbaum DH, Caty MG, Langer JC (2009) Development of a standardized definition for Hirschsprung’s associated enterocolitis: a Delphi analysis. J Pediatr Surg 44:251–256

    Article  Google Scholar 

  12. Elhalaby EA, Coran AG, Blane CE et al (1995) Enterocolitis associated with Hirschsprung’s disease: a clinical-radiological characterization based on 168 patients. J Pediatr Surg 30:76–83

    Article  CAS  Google Scholar 

  13. Wang XQ, Xu SJ, Wang Z, **ao YH, Xu J, Wang ZD et al (2018) Robotic-assisted surgery for pediatric choledochal cyst: case report and literature review. World J Clin Cases 6:143–149

    Article  Google Scholar 

  14. Meehan JJ, Sandler A (2007) Pediatric robotic surgery: a single-institutional review of the first 100 consecutive cases. Surg Endosc 22:177–182

    Article  Google Scholar 

  15. Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T et al (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138:777–784

    Article  Google Scholar 

  16. Sodergren MH, Darzi A (2013) Robotic cancer surgery. Br J Surg 100:3–4

    Article  CAS  Google Scholar 

  17. Herron DM, Marohn M, SAGES-MIRA Robotic Surgery Consensus Group (2008) A consensus document on robotic surgery. Surg Endosc 22:313–325

    Article  CAS  Google Scholar 

  18. Van Haarsteren G, Levine S, Hayes W (2009) Pediatric robotic surgery: early assessment. Pediatrics 124:1642–1649

    Article  Google Scholar 

  19. Berlinger NT (2006) Robotic surgery-squeezing into tight places. N Engl J Med 354:2099–2101

    Article  CAS  Google Scholar 

  20. Dawrant MJ, Najmaldin AS, Alizai NK (2010) Robot-assisted resection of choledochal cysts and hepaticojejunostomy in children less than 10 kg. J Pediatr Surg 45:2364–2368

    Article  Google Scholar 

  21. Sherman JO, Snyder ME, Weitzman JJ, Jona JZ, Gillis DA, O’Donnell B et al (1989) A 40-year multinational retrospective study of 880 Swenson procedures. J Pediatr Surg 24:833–838

    Article  CAS  Google Scholar 

  22. Podevin G, Lardy H, Azzis O, Branchereau S, Petit T, Sfeir R et al (2006) Technical problems and complications of a transanal pull-through for Hirschsprung’s disease. Eur J Pediatr Surg 16:104–108

    Article  CAS  Google Scholar 

  23. Hadidi A (2003) Transanalendorectal pull-through for Hirschsprung’s disease: experience with 68 patients. J Pediatr Surg 38:1337–1340

    Article  CAS  Google Scholar 

  24. Georgeson KE, Robertson DJ (2004) Laparoscopic-assisted approaches for the definitive surgery for Hirschsprung’s disease. Semin Pediatr Surg 13:256–262

    Article  Google Scholar 

  25. Bawazir OA (2020) Laparoscopic-assisted transanal pull-through in Hirschsprung disease: does laparoscopic dissection minimize anal overstretching? J Laparoendosc Adv Surg Tech A 30:338–343

    Article  Google Scholar 

  26. Tomuschat C, Zimmer J, Puri P (2016) Laparoscopic-assisted pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int 32:751–757

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Prisma Health Children’s Hospital, 9 Richland Medical Park Dr, Columbia, SC, 29203, USA

    Carlos Delgado-Miguel & Juan I. Camps

  2. Department of Pediatric Surgery, La Paz Children’s University Hospital, Madrid, Spain

    Carlos Delgado-Miguel

Authors
  1. Carlos Delgado-Miguel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan I. Camps
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlos Delgado-Miguel.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Delgado-Miguel, C., Camps, J.I. Robotic Soave pull-through procedure for Hirschsprung’s disease in children under 12-months: long-term outcomes. Pediatr Surg Int 38, 51–57 (2022). https://doi.org/10.1007/s00383-021-05018-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-021-05018-6

Keywords

Search

Navigation