Minimal Invasive Surgery and Therapy (MIS and MIT) in Hirschsprung's Patients
Nilmini Wickramasinghe (Illinois Institute of Technology, USA), Giuseppe Turchetti (Scuola Superiore Sant’Anna, Italy), Barbara Labella (Scuola Superiore Sant’Anna, Italy), Andrea Moglia (Scuola Superiore Sant’Anna, Italy), Arianna Menciassi (Scuola Superiore Sant’Anna, Italy) and Paolo Dario (Scuola Superiore Sant’Anna, Italy)
Copyright: © 2008
The generally accepted treatment for Hirschsprung’s disease is through surgical intervention. Currently, the recognized techniques include the Swenson technique, which is less frequently used as the operation is delicate and can give rise to complications; the Duhamel technique, which is arguably the simplest approach and consistently provides good results; and the Soave technique, which also provides good results but is often more complex than the Duhamel approach. However, surgical and diagnostic procedures of the future will evolve from embracing current technologies that enable minimally invasive approaches to extremely targeted, localized, and high-precision endoluminal techniques. This requires entirely new types of surgical tools capable of entering the human body through natural orifices (by insertion, ingestion, or inhalation), very small incisions (injections), or even through skin absorption and maybe configuring themselves in complex kinetic structures at the specific site of intervention. Moreover, such approaches necessitate modification of classic surgical techniques. While the advantages of minimally invasive surgery and minimally invasive therapy (MIS and MIT) are widely acknowledged, this chapter serves to highlight the advantages of such procedures in pediatric medicine, both at the diagnostic and intervention levels and the consequent implications to classic surgical techniques. The particular focus of the chapter pertains to the specific advantages the following techniques can bring into pediatric diagnostic and surgical techniques in the case of Hirschsprung’s disease: (1) endoluminal miniaturized tools for gastrointestinal endoscopy, (2) gastrointestinal capsules for digestion (e.g., M2A capsule), and (3) laparoscopic tools for surgery. Both technological and economic perspectives are discussed.
Key Terms in this Chapter
Minimally Invasive Surgery (MIS): Surgery performed by entering the body through a small orifice.
Endoluminal Capsule Monitoring: A noninvasive medical diagnostic procedure that uses a miniaturized wireless radio transmitter embedded into an ingestible water-tight capsule to monitor the gastrointestinal system.
Endoscopy: Looking inside the human body for medical reasons.
Hirschsprung’s Disease: Also known as congenital megacolon, occurs when some of the nerve cells in the intestines do not form properly.
Minimally Invasive Techniques (MIT): Techniques required to ensure that MIS can occur.