Primary Laparoscopic Assisted Kimura Patch Reconstruction of an Ileal Hirschsprung's Disease in a Neonate
Abstract
An inlay patch graft of aganglionic right colon (Kimura patch) was shown to enhance water absorption in children with total colon Hirschsprung's disease (HD). This operation is usually performed on affected children after the initial ileostomy is shown incapable of absorbing adequate moisture from the stool. In most instances, only after a period of adjustment are the combined ileum and colonic patch pulled through and anastomosed to the anus. At the time of laparoscopic pull-through in a neonate with HD and Down's syndrome, it was found that long segment (ileal) disease was present, and primary Kimura patch reconstruction was undertaken. To our knowledge, this is the first recorded description of laparoscopic assisted Kimura patch reconstruction as a primary operation in a neonate.