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

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Dr Nada Child Surgeon (Kuala Lumpur)Dr Nada Child Surgeon (Kuala Lumpur)4.9 Based on 251 reviews fromSee all reviewsMuzlina Mohamad JamilMuzlina Mohamad Jamil ★★★★★ Highly recommend Dr. Nadarajan from Pantai Bangsar. Caring, professional, and great with children. Thank you for the excellent care and reassurance throughout our visit.mohd rahimi Yaacobmohd rahimi Yaacob ★★★★★ I would like to express my sincere appreciation to Dr. Nada for his excellent service and care.My son, Aryan was having constipation problems, and Dr. Nada handled the consultation with great professionalism and kindness. The way he spoke to my son was very friendly, reassuring and convincing, which made my son comfortable and willing to listen to his advice.Following Dr. Nada's recommendations, my son has changed his eating habits and meal choices significantly. We are happy to see that he is recovering well and showing positive improvement.Thank you, Dr. Nada, for your dedication and excellent care. Highly recommended!titien marlinatitien marlina ★★★★★ Tempatnya nyaman.... Penjelasan Beliau sangat baik dan jelas. Rekomend untk orang tua yang mau memeriksa kan anak anaknyaAlwani AzizAlwani Aziz ★★★★★ Very friendly and gentle with children. He explained my kid’s condition concisely and made us feel at ease. The consultation room had toys for the kids to keep them entertained while parents are being consulted. Highly recommended paed if you’re looking for easy-going and approachable doctor!Juliana DamanikJuliana Damanik ★★★★★ Dokter nya sangat baik,ramah..Kami senang x bisa bertemu dokter nada.Thankyou dokter,sehat selalu dokter🙏ROSMINI AHMADROSMINI AHMAD ★★★★★ Tqq for the professional service n warmth to Arissa Iris Hazha n clinic nurse so committed n helpfulSo fatherly 💝HongkuanHongkuan ★★★★★ Dr. Nada is one of the best surgeons we have ever met. My cousin had already undergone 6 surgeries in Thailand and 5 surgeries in Cambodia, and our family was almost losing hope. A few months ago, his condition became problematic again, and we did not know where to turn for help.After searching for a specialist, we found Dr. Nada. From the very beginning, he was incredibly responsive and took the time to answer our questions and concerns. Throughout the entire process, he provided outstanding care and professionalism.What impressed us most was his compassion and dedication. Even though many of our family members do not speak English, Dr. Nada always found ways to communicate clearly and make sure we understood everything. He treated us with kindness, patience, and respect, which made a very difficult situation much easier for our family.We are truly grateful for the care and support he provided. Thank you, Dr. Nada, for giving us hope and for taking such wonderful care of my cousin. We highly recommend him to any family looking for a skilled and caring pediatric surgeon.Wei Seng NgWei Seng Ng ★★★★★ Dr.Nada was very professional and caring when treating my son. He explained my son’s condition clearly and answered all our questions patiently. We felt reassured and confident with his advice and treatment plan. Thank you for the excellent care and attention.Bharath ReddyBharath Reddy ★★★★★ Thank you, doctor, for the excellent care and support throughout our son’s treatment. The surgery went well, recovery has been smooth, and today we were happy to hear he can return to normal activities. Highly recommended.CHEE YANG LEECHEE YANG LEE ★★★★★ Thank you, Doctor Nada, for your kindness and professionalism. You explained my child’s condition very clearly and patiently, which gave us a lot of reassurance. You are also very friendly and caring throughout the consultation. We truly appreciate your help and dedication. Highly recommended!michelle alverinamichelle alverina ★★★★★ Oh dr Nada is the best. His explanation is very detail, easy to understand & relieving . He’s very good with kids as well. Love to recommend dr Nada to every parents who need to consult with pediatry urology specialist!Stefvifans StefvifansStefvifans Stefvifans ★★★★★ The Doctor so friendly and explain things so clearly. He explained to us so detail until we understood what happenedFaidhi SobriFaidhi Sobri ★★★★★ Thank you Dr for 2 years recovery process for my son. Alhamdulillah everything went well for first and 2nd stage surgery. He is a very experience Dr for kids surgery and recommended to allSiti Zolkafli86Siti Zolkafli86 ★★★★★ “I am very satisfied with the service from Dr Nada. The doctor is very professional, explains the condition clearly and in an easy-to-understand way. The consultation was comfortable and not awkward. Highly recommended!nadia novaranadia novara ★★★★★ Pernah bawa anak Operasi hipospadia dengan dokter nada di KL.Dokternya baik, kasih alternatif agar biaya operasi bisa lebih murah gimana. Sangat membantu. Dokternya juga Ramah. Pokoknya oke 👍Aida RamliAida Ramli ★★★★★ Love dr nadarajan. Very good with kids and asnwer all questions we had. Also always abailable if we have any questionssyaqir wahabsyaqir wahab ★★★★★ Doktor yang sangat berpengalaman.shada ikramshada ikram ★★★★★ Glad we came here! Dr Nada provided the correct treatment based on my son’s condition. The explanation was clear, and we have seen good improvement since.Tim TalbotTim Talbot ★★★★★ Excellent from beginning to start. Dr Nada is gentle, clear regarding treatment and genuinely cared for our child - with the end result, a successful and minimally invasive surgery. We couldn't have been happier with the treatment.Thank you so much!Hishiko TVHishiko TV ★★★★★ 很细心,很友善的医生!eddy chineddy chin ★★★★★ Highly recommended. Dr. Nada is very attentive and thorough.Simbar DubeSimbar Dube ★★★★★ My son recently had a keyhole surgery performed by Dr. Nada, and I cannot speak highly enough about the experience.From the very beginning, Dr. Nada was calm, reassuring, and incredibly kind. As a parent, it is naturally stressful when your child needs surgery, but he took the time to explain everything clearly and made sure we felt comfortable and informed throughout the process. His professionalism and confidence immediately built trust.What stood out the most was how he treated my son. Instead of approaching the situation in a purely clinical way, he connected with him on a human level. He spoke to him kindly, made him feel safe, and after the procedure he even gave him a teddy bear. That small gesture meant a lot. It turned what could have been a frightening experience for a child into something much more comforting.The surgery itself went very well, and the care we received from Dr. Nada and the team was excellent. It is clear that he not only has great skill as a surgeon, but also genuine compassion for his patients.I am deeply grateful for the care he provided to my son, and I would highly recommend Dr. Nada to any parent looking for a skilled and caring doctor.esther kah yanesther kah yan ★★★★★ Dr Nada is a very detailed doctor in which he explained all the conditions to me about my baby, before deciding to have surgery. And also he will patiently teach us how to exercise for my baby, for post-surgery recovery purpose. Strongly recommend this doctor to all the parents if your baby is having tongue tie issue.Ashraf RafiuddinAshraf Rafiuddin ★★★★★ Good doctor. Very friendly. Good with children. Successfully completed a surgery for my 1 year old baby boydessy tandessy tan ★★★★★ Dr Nada is so communicative and a good doctorMánarina NájibMánarina Nájib ★★★★★ Pengalaman yang baik Doktor yang peramah dan explaination yang bagusWeng Soon ThamWeng Soon Tham ★★★★★ Wonderful experience with Dr Nada. We had concerns with our child but reassurance was given after a detailed examination and consultation. Reassured us surgery is not needed and adviced us what we could do to help resolve the issue. Very kind and gentle doctor. Would highly recommend!Nazihah MNNazihah MN ★★★★★ ​We couldn't have asked for a better experience with Dr Nadarajan for our son's hypospadias repair. From the initial consultation through the recovery process, the care was exceptional. The 2 stages surgeries was a success, and all of our follow-up appointments were incredibly smooth and reassuring. Most importantly, the doctor made us feel informed every step of the way. We are so grateful! Thank you very much Dr. Nada and his assistant, Su for the great service.izzaty nizamizzaty nizam ★★★★★ Alhamdulillah consultation dengan Dr Nada sgt membantu. X jadi operate hydrocele. Tengok next year, Harap perubahan lebih baik.Felix HermantoFelix Hermanto ★★★★★ Terima kasih Dokter Nada sudah mengobati hernia dengan sempurnaDokter sangat ramah dan menjelaskan dengan teliti dan jelasTerima kasih juga sudah memperbaiki sunat anak saya dengan baikSiah Yee PingSiah Yee Ping ★★★★★ 这个医生很厉害,很细心👍👍👍Regina LoireRegina Loire ★★★★★ The doctor is very great, my child was lucky to meet Doctor Nada, his hernia was curedSyafa AnnasyaSyafa Annasya ★★★★★ Anak laki2 saya Muhammad Syaqif Alfarizqi 2x melakukan operasi undesensus testis bilateral bersama dr Nada, Best dr 🥰 terimakasi dr 🙏🙏DelbertDelbert ★★★★★ My son (1 year old) has a Hernia and we came from Indonesia for a treatment and doctor suggested an operation.Before the operation, doctor has explained in detail how the operation works and what effects may (very rarely) occur.H+1 After the operation was done my son doesn’t feel pain and can return to normal activitiesThe doctor very friendly and informative. We are so grateful can meet doctor NadaDavid LimDavid Lim ★★★★★ Hi i am from indonesia, my son 1 years old get Hernia inguinal , and got surgery by doctor Nada. Doctor Nada is a best doctor i ever meet , he very patient to explain all the information and process of surgery before the surgery. The surgery is success and my son dont even feel pain at all after the operation, thankyou very much doctorYosie NovianliusYosie Novianlius ★★★★★ We're almost hopeless before meeting Dr. Nada, imagining that our 12-month-old baby might need surgery due to a diagnosis of UDT/retractile testis.However, we found new hope after meeting Dr. Nada. He is very friendly, calming, and took the time to explain everything clearly to us. He even drew diagrams and showed us his article, explaining that our son’s condition does not require surgery and is completely normal.We were extremely relieved.Additionally, our 12-month-old nephew underwent surgery twice with Dr. Nada, and both procedures were a great success.Ashraf MakkiAshraf Makki ★★★★★ I cannot express enough gratitude to Dr. Nadarajan for the exceptional care he provided to my son. He performed a laparoscopic hernia repair with incredible precision and skill.​From the very first consultation, Dr. Nadarajan was professional, patient, and highly reassuring. He took the time to explain the procedure in detail, which put our minds at ease. The surgery was a complete success, thanks to his great expertise in minimally invasive techniques.​What truly sets him apart is his outstanding bedside manner. His follow-up care before and after the surgery was exemplary; and he ensured my son's recovery was on track. We are truly blessed to have found such a brilliant and surgeon. Highly recommendedHelen YaoHelen Yao ★★★★★ Dr. Nada is a very kind and patient doctor. My 10-year-old son went to the emergency department with abdominal pain and had difficulty describing what he was feeling. Dr. Nada was excellent at guiding him to express his pain clearly. We highly recommend Dr. Nada to other parents.Hazwan MustafaHazwan Mustafa ★★★★★ Experienced. Making wise and fast suggestions to us. Thank you Dr.js_loader

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