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Anorectal Malformation – Why Paediatric Laparoscopic Surgery Is Best

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

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