Modified Transanal Swenson Pull-through Technique for Hirschsprung Disease: Improving Safety by Minimizing the Risk of Iatrogenic Organ Injury

Abstract

MODIFIED TRANSANAL SWENSON PULL-THROUGH TECHNIQUE FOR HIRSCHSPRUNG'S DISEASE: IMPROVING SAFETY BY MINIMIZED RISK OF IATROGENIC ORGAN INJURY The present invention relates to a surgical technique for Hirschsprung's disease. Transanal Swenson-like pull-through is the most commonly used procedure in the management of Hirschsprung's disease. This procedure requires adequate surgical experience and skill to prevent accidental injury to organs located anterior to the rectum, which can lead to long-term complications. We conducted a retrospective study of Hirschsprung's patients who underwent the Swenson-like pull-through procedure at our institution between 2020 and 2025. A total of 76 patients were enrolled in the study; 46 patients underwent the standard Swenson-like pull-through procedure, with one case of urethral injury occurring during the operation.In contrast, 30 patients underwent modified transanal Swenson-like pull-through, and no anterior organ injury was observed in this group. Furthermore, patients in both groups, with both standard and modified procedures, demonstrated similar and satisfactory functional outcomes. The modified transanal Swenson-like pull-through technique for Hirschsprung's disease has been shown to be safe and effective in preventing iatrogenic anterior organ injury during dissection, as well as providing good functional outcomes. The safety profile and favorable outcomes suggest that this modified approach should be considered in surgical training and technique selection, particularly in situations where preventing iatrogenic anterior organ injury is a priority.