Pediatric congenital megacolon is a common disease in pediatric surgery and requires surgical treatment. There are several surgical methods with their own advantages and disadvantages, and since 1998, transanal drag-out Soave megacolon radical surgery has been recognized worldwide for its minimally invasive and effective results. However, there are still many children who cannot be dragged out all the diseased intestine through the anus due to their age or long segment lesions, or the high tension of the intestine after being held out causes recurrence. Therefore, for children with long stenosis or those older than 3 years old, laparoscopic assistance should be used to free and release the intestinal canal. Li Aiwu, Department of Pediatric Surgery, Qilu Hospital, Shandong University
Laparoscopic-assisted radical resection of megacolon is generally performed by the 3 trocar method, with the umbilical hole entering the scope and one operating forceps in the right lower abdomen and one in the left upper abdomen, first exploring the intestinal lesion, and taking a piece of plasma muscle layer biopsy from the migrated, dilated and normal segments to find ganglion cells; then freeing the stenotic and migrated segments of the intestine with ultrasonic knife, and disconnecting the mesentery from the tertiary vessels; then freeing the dilated segment of the intestine, and disconnecting the mesentery from the secondary vessels to then release the splenic flexure and transverse colon lateral peritoneum and mesentery until the roughly normal intestine can be detached from the anus, and finally transfer to anal surgery, drag out and remove the diseased intestine, and anastomose with the rectal mucosa. The laparoscopic technique has greatly improved the clinical effect of transanal drag-out treatment of megacolon, which is really minimally invasive, aesthetic, efficacious and socially beneficial.