Typical case 8: laparoscopic anoplasty.
Neonate, male, 1 month, Wt, 5.06 kg. He was admitted to the hospital with “1 month post-anal atresia colostomy”.
Diagnosis: congenital anal atresia with fistula in the rectal prostate, post colostomy.
On April 14, 2014, laparoscopic anoplasty was performed under endotracheal general anesthesia.
Laparoscopically, the rectum was freed with a 5mm ultrasonic knife and electric hook to the rectourethral fistula. Bilateral vas deferens and ureters were avoided. The rectourethral fistula was ligated with sutures tightly against the urethra and an additional ligature was made to dissociate the rectourethral fistula.
Surgical surgeon team: Dr. Wu-Ping Ge, chief surgeon, Dr. Jia-Liang Zhou, attending surgeon, and Dr. Gang Liu.
Comments.
1. The staging of congenital anal atresia now uses the 2005 staging criteria. For congenital anal atresia with recto-vesical fistula or rectoprostatic fistula, the traditional surgical method is abdominal-sacral-perineal anoplasty.
2, congenital anal atresia in the type of difficulty is “a cavity anus” of the posterior sagittal anus, vaginoplasty (completed in one phase), “congenital anal atresia with rectal bladder fistula or rectal prostate fistula” of laparoscopic anoplasty. All of them are well performed in our neonatal surgery department.
Preoperative X-ray colonography film
Preoperative MRI film
Pre-operative pictures
Preoperative perineal picture
Intraoperative laparoscopic ligation of the rectourethral fistula
Abdominal laparoscopic puncture opening at the end of surgery
Postoperative formed anus