Hirschsprungs Disease – Why Paediatric Laparoscopic Surgery Is Preferred

Picture of 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

Paediatric Surgeon & Urologist

Paediatric Surgeon

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Dr Nada Child Surgeon (Kuala Lumpur)Dr Nada Child Surgeon (Kuala Lumpur)5.0 Based on 181 reviews fromSee all reviewsChelsea 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..Yau HunYau Hun ★★★★★ My child had surgery here performed by Dr. Nada and has been following up for a few years. The doctor is empathetic, patient, ethical, and professional, and the nurse is also very attentive and kind.Christini HooChristini Hoo ★★★★★ Dr Nada is a very good, assuring and experienced doctor. We are glad can meet a doctor like himAshley ZulkapeliAshley Zulkapeli ★★★★★ Accomodating, kind, detailed explanation. Could see why hes getting excellent reviews. Kind nursing staffs too!Danny KoayDanny Koay ★★★★★ Very experience doctor and professional. Highly recommended.Donna OctaviaDonna Octavia ★★★★★ Dokter Nada is very nice, professional & very very very detailed! I would definitely come back and see him whenever theres problems with my son. Thank you so much doctor! 🥰Cyrus WongCyrus Wong ★★★★★ I am so glad that I was referred to Dr Nada when I found out my 2 month old son was diagnosed with inguinal hernia. Dr Nada has always been calm and reassuring, he listens and explains things patiently and thoroughly. My son’s keyhole surgery went very well and he is recovering fast. Thank you so much!Nur HafizahNur Hafizah ★★★★★ Dr Nada was extremely kind and patient. He was reassuring and didn’t suggest unnecessary interventions. Definitely one of the best Paeds surgeons around!Jose Luis LarrosaJose Luis Larrosa ★★★★★ Dr. Nada is an exceptional pediatrician who combines professionalism with a warm, friendly demeanor that immediately puts both parents and children at ease. From the moment you walk into his office, it's clear that he genuinely cares about the well-being of his young patients. His gentle approach and patience in explaining everything to both parents and children are truly commendable.Ram GollapalliRam Gollapalli ★★★★★ Doctor is very friendly and treated well. My kid got Hernia surgery, after we talked to Dr Nada we felt so relax and everything went well. He gavemany suggestions and answered all our doubts. I m strongly recommending.Thanks a lot Dr Nada.Saidatul SyafiqahSaidatul Syafiqah ★★★★★ The Dr is superb with his explaination and consultation. The wording and terms that he uses to explain is easier to understand for us as a parents with no medical background. We have come to the right place. If we can give hundred stars of rating, we would definitely give it happily. Thanks you much Dr!niki khorniki khor ★★★★★ Dr. Nada 是一位非常有耐心的医生,他乐意解答父母的每一个疑问。他的细心和耐心让父母对他充满信心,令我们愿意将孩子百分之百地交给他。手术后,他会亲自检查孩子的伤口,并与家人沟通孩子的康复进展以及接下来的治疗计划。这种关怀和沟通让家人感到放心和安心。Masao WijayaMasao Wijaya ★★★★★ Hasil operasi sangat memuaskan, dan proses operasi juga sangat mulus, anak tidak ada trauma sama sekali setelah operasi. Sangat recommended , terimakasih dr nada dan nurse sue.js_loader

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