This video presents a recorded webcast of an Imperforate Anus Pull-Through Procedure performed by Dr. Steven Rothenberg.

Imperforate anus repair is surgery to correct birth defects involving malformation of the rectum and anus.

Normally, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body.

Infants with imperforate anus defect, however, have malformations of the rectum and anus in which abnormal development leads to growth of skin over the anus and incomplete development of the rectum.

As a result, these infants have either no opening through which stool can pass, or a very small opening that allows only a small amount of stool to pass out of the rectum. This very small opening is often accompanied by fistulas, which are abnormal channels that connect skin to bowel.

Numerous laparoscopic operations have replaced the traditional open procedure in both adults and children. These new procedures have allowed access to body cavities without significantly traumatizing intervening tissue. The laparoscopically assisted anorectal pull-through (LAARP) for high anorectal malformations (ARM) uses fundamental concepts learned from decades of high ARM repair and incorporates modern technologic advancements in surgical instrumentation and techniques. This laparoscopic approach offers good visualization of an infant's deep pelvis with a reconstruction technique that minimizes trauma to important surrounding structures.

The laparoscopically assisted anorectal pull-through (LAARP) for repair of high imperforate anus utilizes minimal perineal dissection, preservation of the distal rectum, and accurate placement of the rectum within the levator ani and external anal sphincter muscle complex.

KARL STORZ Endoscopy is making this recorded webcast available as part of their ongoing efforts to provide education and training in pediatric minimally invasive surgery.