The usefulness of “Finger-assist” during the laparoscopically assisted anorectal pull through

Abstract

Laparoscopically assisted anorectal pull-through (LAARP) is one of the surgical procedures for anorectal malformations (ARM) with rectourethral fistula. However, it is sometimes difficult to obtain favorable laparoscopic view and adequate dissection of fistula. To obtain the tactile sensation of surgeons, ‘Finger-assisted’ laparoscopic surgery has been introduced for small numbers of pediatric patients. We developed the ‘Finger-assisted’ technique during LAARP. From 2012 to 2016, three patients with rectoprostatic fistula underwent Finger-assisted LAARP. There was no open conversion or complication. Furthermore, post-operative barium enema revealed the adequate resection of fistula and favorable anterior angulation of the rectum. Finger-assisted LAARP is feasible surgical option for ARM with rectourethral fistula. Keywords: Imperforate anus, Wound retractor, Palpation