Operations for Hirschsprungs Disease

Operations for Hirschsprungs Disease is done to bypass or remove the part of the colon that is lacking nerve cells.

July 25, 2022

Operations for Hirschsprungs Disease is done to bypass or remove the part of the colon that is lacking nerve cells.

Some facts about Operations for Hirschsprungs:

  • The large intestine (colon) is affected in Hirschsprung's disease causing problems with passing stool.
  • The condition is present at the time of birth of a child as a result of missing nerve cells in the muscles of of the colon of the baby.
  • Usually, a newborn baby who has Hirschsprung's disease can't have a bowel movement in the days after birth.
  • The condition might not be detected until later in childhood in mild cases.
  • Surgery need to be done to bypass or remove the diseased part of the colon in this disease.

Preparation for Operations for Hirschsprungs Disease:

  • You need to stop taking medications that may thin your blood, such as ibuprofen (Advil) or aspirin a few weeks before your surgery.
  • You should stop smoking temporarily or permanently if you’re ready to quit as smoking can make it harder for your body to heal after surgery.
  • You need to wait for any existing flu, fever, or cold to break.
  • Most of your diet should be replaced with liquids and laxatives should be taken to empty your bowels.
  • You may also need to only drink water or other clear liquids, such as broth or juice in the 24 hours before your surgery.
  • Do not eat or drink anything for up to 12 before the surgery.
  • Any medications that your surgeon gives you should be taken right before surgery. 
  • A sample of colon tissue will be removed for testing which is known as biopsy.
  • Abdominal X-ray using a contrast dye will be done that show a clear contrast between the narrow section of bowel without nerves and the normal but often swollen section of bowel behind it.
  • An anal manometry can also be done to measure control of the muscles around the rectum

Procedure for Operations for Hirschsprungs Disease:

  • Operations for Hirschsprungs Disease can be done either by  a pull-through surgery or an ostomy surgery.
  • The lining of the diseased part of the colon is stripped away and then  the normal section is pulled through the colon from the inside and attached to the anus in a pull-through surgery.
  • Usually, this procedure is done using minimally invasive (laparoscopic) methods, operating through the anus.
  • Surgery might be done in two steps in children who are very ill.
  • An opening will be created by the surgeon in the child's abdomen which will be connected to the top healthy portion of the colon after removing the deseased abnormal portion of the colon.
  • A  bag that attaches to the end of the intestine that protrudes through the hole in the abdomen (stoma) which will be used for the stool to leave the body through the opening.
  • Time is provided for the lower part of the colon to heal in this.
  • A second procedure is done to close the stoma and connect the healthy portion of the intestine to the rectum or anus once the colon has had time to heal.
  • Most children are able to pass stool through the anus after surgery.
  • Diarrhea, Constipation, Leaking stool (fecal incontinence) and Delays in toilet training are some of the possible complications that may improve with time.
  • A bowel infection (enterocolitis) may be a risk after surgery.