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Endoscopic Transanal Soave Procedure (ETaS) Using a LAPPROTECTOR for Hirschsprung Disease.

Created on 14 Jul 2026

Authors

Yusuke Yamane, Shota Shinohara, Nobuhito Ogata, Koshin Funabara, Keisuke Ozeki, Takuro Fujita, Taiichiro Kosaka, Akihiko Soyama, Susumu Eguchi

Published in

Asian journal of endoscopic surgery. Volume 19. Issue 1. Pages e70345.

Abstract

Short-segment Hirschsprung disease is usually managed by a transanal Soave procedure, sometimes with laparoscopic assistance when proximal mobilization is difficult. We describe endoscope-assisted transanal Soave (ETaS) using a Lap Protector-based access platform without laparoscopy. A 6-year-old boy with constipation since infancy underwent surgery after rectal mucosal biopsies at ages 3 and 5 showed positive acetylcholinesterase staining. Mucosectomy was started 5 mm proximal to the dentate line and extended ~2 cm before closure of the distal cuff. A sealed transanal endoscopic workspace was then created with a LAPPROTECTOR and EZ-Access, allowing deep pelvic dissection and proximal mobilization to the sigmoid-descending junction under stable pneumorectum. After confirmation of mesenteric orientation and ganglion cells on frozen-section full-thickness biopsy, coloanal anastomosis was completed. Operative time was 225 min with minimal blood loss, no abdominal ports, and an uneventful postoperative course. This technique may be a useful option in selected pediatric patients.

PMID:
42444077
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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