Anorectal Malformation – Why Paediatric Laparoscopic Surgery Is Best

Picture of Dr Nada Sudhakaran

Dr Nada Sudhakaran

Paediatric Surgeon & Urologist

Laparoscopic Surgery Is the Preferred Method for Paediatric Anorectal Malformation Treatment in Malaysia

Anorectal Malformation Laparoscopic Surgery

Hello, I am Dr. Nada, a paediatric surgeon based in Kuala Lumpur, Malaysia. Each day, my interactions with young patients and their families reinforce my commitment to child health and well-being. As part of this journey, I regularly encounter the courage and resilience of children born with anorectal malformations, a complex congenital disorder that affects both boys and girls.

Today, I aim to explore this topic further, focusing on why paediatric laparoscopic surgery, also known as the keyhole technique, is emerging as the preferred method for addressing this condition.

In this article, you will learn about anorectal malformation, the traditional surgical methods used for its treatment, and the drawbacks of these techniques. Further, I will elaborate on the keyhole technique, detailing its process and the numerous benefits it brings to the table.

This article aims to equip you, as parents and caregivers, with valuable knowledge and insights that can help you make informed decisions regarding your child’s health and well-being.

Understanding Anorectal Malformation

What is Anorectal Malformation?

Anorectal Malformation is a congenital disorder characterised by an abnormal formation of the anus or rectum.

In boys, the anomaly often involves a connection between the rectum and the urinary tract, typically resulting in the absence of an anal opening. On the other hand, in girls, the condition usually entails a connection with the vagina.

This article focuses on Anorectal Malformation in boys, where the rectum predominantly connects to the urethra, a critical component of the urinary tract, located deeper inside the abdomen.

Anorectal Malformation in boys
Anorectal Malformation in girls
For a more detailed article on Anorectal Malformation click HERE

Traditional Surgical Method for Anorectal Malformation

Historically, the surgical treatment for Anorectal Malformation in boys and girls has involved a significant incision in the lower body area. For boys, the cut extends from the scrotum to the spine, while for girls, it spans from the vagina to the spine.

The Downside of Traditional Surgery

This surgical approach cuts through crucial structures and muscles necessary for future continence of the anus. As a result, the recovery process is generally more arduous and painful for the child. Moreover, because of the extensive incision involved, the recuperation period is extended, causing additional discomfort to the child and anxiety to the parents.

Open Surgery
Open surgery incisions – large in size to allow access to hand manipulation by surgeon

The Rise of Paediatric Laparoscopic Surgery for Anorectal Malformation

Contrary to the traditional method, laparoscopic surgery or the ‘keyhole’ technique offers a more advanced, efficient, and less invasive approach to treating Anorectal Malformation. This method is favoured by top medical centres worldwide due to its numerous advantages.

The Laparoscopic Technique

In laparoscopic surgery, small incisions are made in the abdomen, including a minor cut in the belly button. This approach enables us to accurately view the connection between the rectum and the urethra or the ‘water pipe’. Subsequently, we can skillfully disconnect this linkage and repair the urinary tract.

Pediatric Appendicitis Surgery
Keyhole surgery incisions – 3 small dots to insert camera and two instruments.

Once this is achieved, a small tract is created at the bottom end, enabling us to pull through the bowel so that it traverses the muscle complex. This step is vital for ensuring the future continence of the child.

Benefits of the Laparoscopic Surgery

Minimal Incisions

Laparoscopic surgery involves only small incisions and avoids cutting any muscles, reducing the risk of infection and speeding up the healing process.

Less Trauma

Compared to the traditional method, this technique is significantly less traumatic as it prevents extensive muscle damage.

Enhanced Continence

The surgery ensures the bowel goes through the muscle complex, a vital step for ensuring the future continence of the child.

Better Recovery

The child experiences less pain post-surgery and enjoys a smoother recovery, reducing stress for both the child and the parents.

Choosing Laparoscopic Surgery for Anorectal Malformation in Malaysia

When it comes to addressing Anorectal Malformation in boys, I firmly believe in the superiority of the keyhole or laparoscopic surgery method. Parents with boys experiencing this condition should seek out a paediatric surgeon experienced in laparoscopic surgery. This modern approach ensures your child experiences minimal incisions, smoother operations, lesser pain, and a vastly improved recovery period.

Together, we can provide a healthier and brighter future for our children.

Remember, early intervention and the right surgical approach can make a significant difference in the long-term health and well-being of children with Anorectal Malformation & other conditions.

Find out more HERE

Media & Patient stories on Dr Nada and Anorectal Malformation

The case of Lew Cheng Xin and how Da-Ai rallied Malaysian’s to raise RM66,000 for his urgent operation (23-06-2021)

Ms Lau’s testimonial

“When my son was born in 2013, the doctor found that his anus was different from other children. He needed to do surgery immediately so that he can defecate normally, and this surgery required huge medical fee that I couldn’t afford. I was worried and afraid.

I decided to send my son to Hospital University Malaya. That was the first time I met Prof Nada. He explained in detailed to me that my son needed 3 surgeries.

The first operation was to put the stoma bag to allow him to poo. The second was to create a new anus and the third surgery is to close the stoma. I was worried and fearful every time when my son underwent surgery, but every time when Dr Nada finished the surgery he came out to comfort me.

He is patient , humble and affable doctor. He always has a smile on his face. Dr Nada saved my child and gave him a new life. Now my son is six years old, he has the same bowel movement as a normal child and healthy growth. Dr Nada is kind, professional, and an awesome, remarkable doctor. We are always grateful for everything he had done for my child.”

Ms Lau – Mother


If you require surgical help with your child, schedule an appointment with Dr Nada and put your mind at ease knowing that your child is in good hands.

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Dr Nada Sudhakaran

Paediatric Surgeon & Urologist

Paediatric Surgeon

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Pantai Hospital Kuala Lumpur

+603-2296 0419

Assunta Hospital PJ

+603-7872 3000

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Dr Nada Child Surgeon (Kuala Lumpur)Dr Nada Child Surgeon (Kuala Lumpur)5.0 Based on 198 reviews fromSee all reviewsNadineNadine ★★★★★ Dr. Nada was absolutely wonderful with my child. He took the time to chat with him in a friendly and humorous way, which really helped my son feel comfortable. His kindness and approach made the whole visit a positive experience.Khai MingKhai Ming ★★★★★ I recently brought my son to Dr. Nada for laparoscopic keyhole surgery for his hernia. The surgery itself went smoothly, and thanks to Dr. Nada's expertise, our son recovered much faster than we expected. Most importantly, my son was back to his usual active self in no time, and we even noticed he became more energetic and less grumpy after the procedure. I highly recommend Dr. Nada to any parent looking for a surgeon who combines professional excellence with compassion.Maznina Lee Faizal LeeMaznina Lee Faizal Lee ★★★★★ Best dpt jumpa Dr.Nada, selalu tengok dekat TT je.. penerangan yg jelas.. dari nervous jadi tenang.. Dr.Nada pandai ambil hati anak, so anak pon tak nangis.. sebelum Dr.Nada nak explain dia kasi ank tenang2 kt belakang tu..so mak2 ni dapatlah focus apa doktor nak cakap.. pepun sangat happy.. thank you Dr. Nada.Jcp YeapJcp Yeap ★★★★★ Dr. Nada is wonderful – very friendly and cheerful. He takes the time to explain everything clearly and always makes sure I feel at ease during the consultation. I truly value his expertise, and I wouldn’t hesitate to recommend him to other.Pavittra Mohan PillaiPavittra Mohan Pillai ★★★★★ We brought our baby (6 months+) to Dr. Nada’s clinic for a tongue tie release, and I cannot thank him enough. Dr. Nada was extremely thorough, caring, and professional throughout the whole process. Looking back, I wish we had done this much earlier when my baby was under a month old—it would have made my breastfeeding journey so much smoother.After the release, we immediately noticed a big difference. My baby feeds much better now, drinking milk from the bottle is easier, and swallowing solids has also improved within a few days. I’m also hopeful to see her relatch soon.Thank you, Dr. Nada, for guiding us through this journey and for your genuine care. I highly recommend Dr. Nada and his clinic to any parent considering a tongue tie release for their baby.Siti AnisdaSiti Anisda ★★★★★ Dear Dr. Nada, Dr Chong, Assunta Team and Pantai Team,I and husband just wanted to extend our sincere gratitude for the excellent care you provided during my son's tongue-tie procedure on 23 September 2025. Your professionalism, kindness, and reassuring approach made a world of difference during what could have been a stressful time for us.Thank you for making both my son and us as parents feel comfortable and well taken care of. We truly appreciate your expertise and compassion.♥️♥️♥️Nichole TanNichole Tan ★★★★★ Doctor very good 👍👍👍VIVEK SASHEENDRANVIVEK SASHEENDRAN ★★★★★ I had a very pleasant experience with Dr Nada. Special needs son had an emergency due to an infection In the gut.Direshkumar PadmanathanDireshkumar Padmanathan ★★★★★ Dr. Nada is very good at handling kids and always very helpful. He makes children feel comfortable and explains things clearly to parents. Highly recommended!koduru lokeshkoduru lokesh ★★★★★ Our experience with Dr Nada was excellent, He was the best person person to treat our child. We are always thankful to Dr Nada.Zurina JusohZurina Jusoh ★★★★★ senang berurusan dgn Dr Nada, anak saya berusia 3,4 hari yang baru dilahirkan terpaksa/ wajib buat operation ESOPHAGEAL ATRESIA SURGERY.penerangan sebelum dan selepas operation dari Doctor sangat meyakinkan kami.skrg anak sudah berusia 4 tahun. alhamdulillahlah sihat. 👍👍👍terima kasih doc. doc membuat kerja dgn cemerlang💪👌👌Vivian YapVivian Yap ★★★★★ Awesome doctor and he’s super good with kidsYi Meng LeongYi Meng Leong ★★★★★ Very experienced and professional dr, gave details info about before,during and after surgeryMohd ShahrilMohd Shahril ★★★★★ Good consultation. Bagus & baik dlam mengendalikan kanak-kanakChelsea EmbChelsea Emb ★★★★★ Dr. Nada is a highly professional pediatrician. He provides clear and thorough medical advice. He is also extremely patient and kind with the children.We are truly grateful to have found such a caring and dedicated doctor. Thank you, Dr. Nada!Sadia HossainSadia Hossain ★★★★★ Dr Nada handled the case of my child really well. He was very good with my child to make them feel at ease and made the me reassured of the process he followed.hong familyhong family ★★★★★ Thank you Dr Nada for doing a successful appendix surgery for me.Dr Nada is very kind and caring.nenvy wantouwnenvy wantouw ★★★★★ Terima kasih dr. Nada, kedua anak laki-laki saya check up ke beliau, sangat puas dengan pemeriksaan yang dilakukan dr. Nada.Putri Ayu PratiwiPutri Ayu Pratiwi ★★★★★ Sangat baik, menjelaskan sangat rasional, menghilangkan kekhawatiran. Dokter terbaiklahAsweni GunasegranAsweni Gunasegran ★★★★★ We’ve had a truly wonderful experience with Dr. Nada. From our very first visit, it was clear that he is not only highly knowledgeable and experienced but also incredibly kind and patient with children.He took the time to listen to our problem, explain things clearly, and never make you feel rushed. My child was at ease and evenlooked forward to the next visit which says a lot!Thank you, Dr. Nada, for your dedication, warmth, and professionalism. We are truly grateful.Wong Hsien WeiWong Hsien Wei ★★★★★ Thank you, Dr. Nada, for your excellent care and support throughout our son’s treatment. He recently underwent keyhole surgery for a hernia, and everything went smoothly, just as you assured us.We were initially very worried about the anaesthesia, but you took the time to explain everything clearly and patiently, which helped us feel at ease.We’re truly glad we followed your advice to go with the minimally invasive approach, the recovery was quick, the pain was minimal, and the scarring was barely noticeable.Your professionalism and calm demeanour gave us great confidence, and we’re very grateful for the care you provided. ☺️👍Clarence Gretha ZetliecClarence Gretha Zetliec ★★★★★ The best doctor ever. He did a choledochal cyst surgery for my daughter, and it was incredible. I really Thank God I found him. Thank you so much doc!Jaya DevanJaya Devan ★★★★★ Friendly and a great doctor. Takes good care of patients. Felt really comfortable being his patient. Got a great treatment from him :)Caan Ee WongCaan Ee Wong ★★★★★ My daughter had a 6 hours keyhole surgery (choledochal cysts) performed by Dr. Nada. Time flies - it has already been a year since the surgery. Thanks to Dr. Nada’s professionalism, my girl is now able to live a normal life and has grown into such an active and sweet girl. Dr. Nada explained everything in detail during each of our visits. Thank you, Dr. Nada—we’re so grateful to know you.nurus sohwahnurus sohwah ★★★★★ I had an excellent experience with Dr. Nada at Pantai Hospital today for my baby's tongue tie treatment. Dr. Nada was incredibly professional, thorough, and caring throughout the process. He not only provided effective treatment but also took the time to teach us exercises to do at home over the next three weeks. The treatment is already showing great results, and I'm truly grateful for his expertise and support. I highly recommend Dr. Nada for anyone seeking care for tongue tie issues. Thank you so much for your excellent service!Tony TanTony Tan ★★★★★ Nice doctor 👍👍👍Dhinaashinee RajendranDhinaashinee Rajendran ★★★★★ We took our daughter in to see Dr. Nada for second opinion when she was diagnosed with inguinal hernia. The initial advise was to wait until she turned 60 weeks. Since she was a premie, they didn’t want to put her under anesthesia too soon. But after consulting with Dr. Nada, he told us to go for immediate surgery and we have no regrets about that decision.As first-time parents, we were nervous due to the difference in opinions about the timing of the surgery. But Dr. Nada and Dr. Uma, the neonatal paediatrician, patiently answered all our questions and eased our concerns.Our daughter did very well and she didn’t seem to be in any pain at all post surgery. We are so glad we chose to see Dr. Nada. He is very professional, responds to all our questions and thoroughly explained the entire process to us. Thank you, Dr. Nada.Simon LeeSimon Lee ★★★★★ Great Dr, soft spoken, friendly, encouraging.Clear details explanation. Highly recommended.ambareesh veerappaodayarambareesh veerappaodayar ★★★★★ Very Friendly and Experienced Doctor...RecommendedBeby Raven ShakeynBeby Raven Shakeyn ★★★★★ The best, super thorough, genuinely cared & explained my son’s condition so well. Would highly recommend Dr Nada to friends and family. Thank you Dr Nada!Vikhna RoobbanVikhna Roobban ★★★★★ best doctor ever!!!My baby was diagnosed at a medical center with a condition, and I was informed that surgery might be required to resolve the issue. However, they advised me to seek a pediatric surgeon elsewhere to perform the procedure. After searching online, I came across reviews about Dr. Nada. I contacted him via WhatsApp late at night, and he responded shortly afterward. We were given an appointment for the next day.During the consultation / physical examination, Dr. Nada carefully assessed my baby and confirmed that the condition do not require surgery and would resolve on its own as the baby grows. I was so relieved. The explanation provided about the condition was clear and easy to understand. We need more doctors like Dr.Nada❤️Yasmin YusoffYasmin Yusoff ★★★★★ Dr Nada explained well with pictures and slides so we could understand better about my baby’s inguinal hernia condition and keyhole surgery.He answered all my questions and concerns and also responded via phone when he was on leave.My baby is recovering well from the surgery. So thank you so much!jugal joshijugal joshi ★★★★★ Doctor Nada and his clinic were extremely pleasant and helpful!Ben OngBen Ong ★★★★★ Smooth procedure and very incredibly friendlyTong KetTong Ket ★★★★★ Doctor very friendly and nice. Thank you 🙏🏻Yessy LimYessy Lim ★★★★★ Thank you Dr.Nadarajan for helping us..I am from Indonesia, my baby was diagnosed with Hirschsprung's disease, after surgery at 2 months old and now my baby is healthy now..Lyndesa KoonLyndesa Koon ★★★★★ Dr Nada is one of the best paed surgeon I’ve met. When I found out my 2 months old daughter have inguinal hernia from my paed, I researched and found Dr Nada’s website, directly WhatsApp him in the middle of the night on my baby’s condition to get his advice. He was very prompt and replied early in the morning to scheduled for a check up. He gave us the assurance that the surgery will be fine for her despite being just 2 months old & was born as a premmie. We took a leap of faith & believed in him with his years of experience, did the surgery the day after. A week after the recovery, my baby is all in smiles and sleeps very well at night no more straining and grunting in pain. I am very thankful and counting my blessing. Thank you Dr Nada.Rizwaan MazirRizwaan Mazir ★★★★★ Dr Nada is very knowledgeable in paediatric surgeon.. give a full detailed explanation in overall. Dr. Nada also very kind and child friendly.. see you tomorrow Dr for next appointment..Hendro ChandraHendro Chandra ★★★★★ Very glad we meet the right doctor with his speciality and experience doing the keyhole surgery to our 2yo daughter (hernia inguinalis). No doubt the best one, thankyou doctor nada. While in the waiting room, there was one patient sharing her experience after fourth surgery with doctor and convinced us that we found the right doctor for our case.Elly YbElly Yb ★★★★★ Doktor yang bagus,mantap sekali..js_loader

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