Hirschsprung Disease Surgery
Introduction
Hirschsprung Disease (HD) is a congenital condition affecting the large intestine. A portion of the colon lacks nerve cells. This results in bowel dysfunction. Chronic constipation and intestinal obstruction invariably follow this condition, which could be fatal if unattended. Surgeons choose Hirschsprung Disease Surgery as the treatment for this condition, and they aim to excise the aganglionic colon so that normal bowel function can be reinstated.
The surgery is typically performed in childhood, and its success greatly improves the patient’s quality of life, reducing the complications that arise from untreated HD. This article will explore the procedure, types, benefits, risks, costs, and the top hospitals in India, particularly in Delhi, that provide this life-changing surgery.
What is Hirschsprung Disease Surgery?
Surgery in Hirschsprung Disease is a medical intervention for the correction of Hirschsprung Disease, which is the occurrence of the absence of nerve cells in certain areas of the large bowel. These lost ganglion cells, which are nerve cells, are required for normal defecation. The surgery involves removing the aganglionic part of the colon and connecting the healthy portion of the intestine to the anus, which restores normal bowel function.
Surgical intervention can be done using different methods. It can be performed as an open surgery, laparoscopic, or transanal procedure. The choice depends on the stage of the disease and the surgeon’s skills.
Why is Hirschsprung Disease Surgery Necessary?
Surgical treatment of Hirschp̀ng Disease is mandatory because, without surgical treatment, the child may suffer from severe constipation, abdominal distension and permanent pain. Developments of untreated Hirschsprung Disease over time can result in bowel perforation, infection (enterocolitis), and growth failure.
The operation removes the nonfunctional portion of the colon and reconstructs bowel function in a manner consistent with normal defecation. Early intervention has beneficial effects on the outcome and quality of life of the patient.
Types of Hirschsprung Disease Surgery
Different surgical approaches are available to cure Hirschsprung Disease, of which the following are the most common:
- Swenson Procedure: In this method, the aganglionic portion is resected and a healthy colon is drawn through the rectum, thereby forming a continuous bowel tract.
- Duhamel Procedure: The procedure consists of the division of the aganglionic segment and the insertion of the corresponding segment into a healthy colon via side-to-side anastomosis.
- Soave Procedure: Similar to the Duhamel approach, the Soave procedure involves removing the aganglionic mucosa and reconnecting the colon via a muscular cuff.
- Transanal Endorectal Pull-Through: In this very small number of access to the colon, which is implemented through the anus, this procedure leads to a speedier recovery and several fewer incisions.
Procedure Steps
The steps for Hirschsprung Disease Surgery are as follows:
- Preoperative Assessment: Radiologists will perform imaging tests and biopsies to authenticate the diagnosis and assess the stage of the disease.
- Anesthesia: The medical team will administer general anesthesia to the child so that the child is completely unconscious and pain-free intraoperatively.
- Surgical Approach: The surgeon will select an open or laparoscopic technique or a transanal technique depending on the child’s condition.
- Resection of Aganglionic Segment: Surgeons will surgically resect part of the colon lacking nerve cells.
- Anastomosis: The medical team will attach the colon properly to the anus, restoring the function of the bowel.
- Postoperative Care: After surgery, the medical team will follow up with the child for postoperative complications, and they will slowly reintroduce feeding.
Benefits of Hirschsprung Disease Surgery
The primary benefits of undergoing Hirschsprung Disease Surgery include:
- Restoration of Normal Bowel Function: When the aganglionic segment is removed, bowel activity is restored, relieving constipation along with associated pain.
- Improved Quality of Life: Using that surgery, people can live normal lives with fewer gastrointestinal difficulties.
- Reduced Risk of Complications: Effective surgical treatment decreases morbidity and postoperative infection, bowel fistula and other complications of untreated Hirschsprung Disease.
Cost of Hirschsprung Disease Surgery
- United States: $20,000 to $50,000
- United Kingdom: The cost can range from $10,000 to $30,000
- India: The average cost ranges from $2,000 to $5,000
Best Hospitals in India for Hirschsprung Disease Surgery
India has many hospitals that provide top-notch care in Hirschsprung disease surgery. Some of the best hospitals are:
- Apollo Children’s Hospital
- Manipal Hospital
- Medanta: The Medicity
Like all surgeries, Hirschsprung Disease Surgery involves the possibility of complications and adverse events.
- Infection: There is a risk of wound infection or bowel infection.
- Bowel Leakage: Following surgery, leakage from the new connection of the bowel is possible.
- Enterocolitis: A serious complication that involves inflammation of the bowel.
- Stool Control Issues: Bowel control problems may be present for some children after surgery, either in a temporary or a long-term state.
- Scar Tissue Formation: Scar tissue can develop in rare instances, causing bowel obstruction.
Recovery
The recovery process after Hirschsprung Disease Surgery generally involves the following stages:
- Initial Recovery: A healthcare team usually monitors the patient for complications during the 5 to 10 days of hospital stay. Gradual Return to
- Normal Activity: At discharge, the child will progressively resume normal activities, but caregivers should prevent strenuous physical activity for several weeks.
- Follow-up Care: Follow-up visits are necessary to control bowel activity and detect any complications.
- Dietary Changes: In postoperative recovery, medical professionals can advise a special diet to prevent bowel irritation.
In most instances, patients with Hirschsprung disease surgery make a good recovery and regain normal bowel habits with few sequelae.
