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Hirschsprungs Disease – Why Paediatric Laparoscopic Surgery Is Preferred

Dr Nada Sudhakaran

Dr Nada Sudhakaran

Paediatric Surgeon & Urologist

Laparoscopic Surgery Is the Preferred Method for Paediatric Hirschsprungs Disease Treatment in Malaysia

As parents, discovering that your child has a medical condition can be an overwhelming and frightening experience. One such condition is Hirschsprung’s disease, a rare disorder of the bowel that primarily affects newborns and infants. This article, inspired by the insights from Dr. Nada Sudhakaran, a paediatric surgeon based in Kuala Lumpur, Malaysia, aims to offer comfort, knowledge, and guidance to parents navigating this challenge.

Drawing from his 25 years experience, Dr. Nada discusses why Laparoscopic surgery (or keyhole surgery) has become the preferred method for treating Hirschsprung’s disease in children. With a deep understanding of the intricacies involved in both traditional and modern surgical methods, he advocates for the advantages of laparoscopic surgery, which he believes offers a more effective solution for patients and their families.

By the end of this article, parents will have a deeper understanding of:

  • The basics of Hirschsprung’s disease and the common complications it causes
  • The traditional approach to surgery and its limitations
  • The benefits and effectiveness of the modern Laparoscopic surgical method

Understanding Hirschsprung’s Disease

Hirschsprung’s disease is a congenital condition that affects the large intestine or colon. Children with this disease lack nerve cells in a portion of their intestines, leading to complications such as obstruction and abdominal distention.

Infant with Hirschsprung’s disease is featured next to a side by side comparison of a healthy colon and the colon of an individual with Hirschsprung’s disease.

An Anatomical Abnormality

In most children, the disease affects the lower 10 centimeters of the colon. The lack of nerve cells in this area causes the intestine to collapse, preventing the feces from being pushed down and expelled, leading to distention and symptoms of obstruction.

Initial Treatment

The initial management involves the introduction of a ‘washout’, a procedure in which a small tube is inserted into the lower part of the intestine to flush out the feces. This step is followed by surgery to correct the abnormality, known as a pull-through operation.

For a full article on Hirschsrpung’s Disease in children click HERE

In the following sections, we will explore why laparoscopic surgery has emerged as the preferred surgical method for treating Hirschsprung’s disease, offering numerous advantages over traditional open surgery.

The Traditional Approach: Open Surgery and Its Complications

In the traditional open surgery method, a cut is made in the abdomen, or an operation is performed at the anal level to pull the normal part of the intestine down to the lower end. The abnormal portion is then removed.

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

Limitations

Despite its widespread use, traditional surgery has limitations. It does not provide a complete view or access to the entire intestine, which may lead to issues with the alignment of the intestine. In addition, it can be challenging to distinguish between the normal and abnormal areas, or identify areas that are dilated.

Potential Complications

The lack of a complete view during the pull-through operation often results in complications. Patients may experience issues if the joint at the bottom end is not correctly connected to the right part of the intestine. Such complications often lead to additional operations, causing unnecessary distress to the child and their families.

The Modern Approach: Laparoscopic Surgery

Dr. Nada advocates for laparoscopic surgery, a minimally invasive method now favored by advanced medical centers around the world. This approach involves making small incisions in the abdomen to access and view the entire intestine, thereby overcoming the limitations of traditional surgery.

Precision and Efficiency

Through laparoscopy, surgeons can accurately identify the correct position for the pull-through procedure. It provides a better view of the intestine, which ensures the alignment is not twisted or kinked, and the right sections of the intestine are joined.

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

Reduced Complications

Laparoscopic surgery significantly reduces the risk of complications related to the pull-through operation. It allows the operation to be done as a single procedure that lasts the child’s lifetime, avoiding the distress and inconvenience of multiple surgeries.

Choosing Laparoscopic Surgery for Hirschsprung’s Disease

The advanced approach results in a smoother surgical journey and a better long-term outcome for children with Hirschsprung’s disease. Parents are thus advised to identify centers that offer paediatric laparoscopic surgery specifically for Hirschsprung’s disease to ensure the best possible care for their child.

In conclusion, laparoscopic surgery has revolutionized the treatment of paediatric Hirschsprung’s disease in Malaysia, offering a safe, effective, and less invasive alternative to traditional open surgery.

As healthcare providers, our goal is to ensure the highest quality of life for our patients, and this method moves us significantly closer to that goal. Parents, equipped with this information, can make informed decisions and feel more confident about their child’s treatment.

Remember, early intervention and the right surgical approach can make a significant difference in the long-term health and well-being of children with Hirschsprung’s disease.

Find out more HERE

Media & Patient testimonials after receiving Hirschsprung’s disease treatment from Dr. Nada

Press Coverage on Dr Nada’s Treatment

Mr Lim’s testimonial

Ms Coco Lee’s testimonial

“I met Dr. Nada through a HD parent Mr. Stephen, when my son was 8 months old, he is a DS child and he diagnosed HD when he was borned. Dr. Nada is a very loving kindness person, he share a lot of knowledge and information with us, he also help my son to reduce a lot of pain and abdominal problems. I hope he keep it up to help more people and found a solution to help more HD patients. Thank you Dr. Nada”

Coco Lee – Mother

Ms Lauren Cu’s testimonial

“Dr Nada attended to my child’s surgery. A very kind hearted surgeon. Two years ago, my child Zelene Lim was diagnosed with Hirschsprungs disease – leaky intestines. It is a rare condition that causes congenital pain since birth.

Dr Nada provided detailed information on the disease. I am saying this not because he attended to my child’s case. But instead he was willing to help us by accepting my son’s case when some surgeons as far as Penang and Singapore had turned us down. He advised us to fly in to Kuala Lumpur as soon as possible, if my child’s condition allows her to travel. I am thankful that my child has since recovered and thank you Dr. Nada for his concern and commitment.”

Lauren Cu – 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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