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Total laparoscopic modified Duhamel operation in combination with transanal endoscopic microsurgery.
[hirschsprung disease]
Laparoscopic-assisted
colonic
resection
has
been
well
described
for
multiple
surgical
indications
and
typically
requires
an
abdominal
incision
for
specimen
removal
that
is
associated
with
most
of
the
postoperative
pain
.
We
report
the
total
laparoscopic
modified
Duhamel
operation
for
megacolon
in
combination
with
transanal
endoscopic
microsurgery
for
transanal
specimen
retrieval
and
anastomosis
to
avoid
the
additional
abdominal
extraction
incision
.
Two
cases
are
presented
:
case
1
was
a
15
-
year
-old
boy
who
presented
with
intermittent
abdominal
distention
,
pain
,
and
constipation
for
3
years
'
duration
and
was
diagnosed
with
Hirschsprung
disease
,
and
case
2
was
a
60
-
year
-old
man
who
presented
with
repeated
attacks
of
incomplete
intestinal
obstruction
for
2
years
'
duration
and
was
diagnosed
with
adult
megacolon
.
They
were
treated
by
the
total
laparoscopic
modified
Duhamel
operation
without
an
abdominal
extraction
incision
in
combination
with
transanal
endoscopic
microsurgery
.
The
operations
were
successfully
accomplished
without
conversion
to
open
surgery
.
The
patients
tolerated
the
procedure
well
,
complained
of
minimal
postoperative
pain
,
and
did
not
require
narcotics
beyond
the
day
of
the
operation
.
No
surgical
complications
occurred
.
Discharge
from
the
hospital
occurred
on
the
ninth
postoperative
day
in
case
1
and
the
13
th
postoperative
day
in
case
2
.
The
total
laparoscopic
modified
Duhamel
operation
in
combination
with
transanal
endoscopic
microsurgery
is
a
feasible
and
minimally
invasive
technique
for
idiopathic
megacolon
and
adult
megacolon
.
This
advanced
surgical
technique
was
developed
by
combining
laparoscopy
with
the
concept
of
natural
orifice
transluminal
endoscopic
surgery
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated