ORIGINAL RESEARCH article
Front. Surg.
Sec. Pediatric Surgery
Rectal Surgery for Hirschsprung's disease in a Single Pediatric Tertiary Care Center: improvement of rectal dissection following the introduction of Robotic Technology
Maria Grazia Faticato 1
Serena Reali 1,2
Michela Cing Yu Wong 1
Stefano Avanzini 1
GIROLAMO MATTIOLI 1,2
1. Giannina Gaslini Institute (IRCCS), Genoa, Italy
2. Universita degli Studi di Genova Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Genoa, Italy
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
ABSTRACT Introduction: Several surgical techniques have been described in the literature for the treatment of Hirschsprung's disease (HD). This study presents our surgical experience in managing patients with HD and the evolution of rectal dissection following the introduction of robotic technology. We developed a novel laparoscopic robot-assisted approach and report our initial experience with Restorative Proctocolectomy with minimal transanal endorectal dissection in HD patients, detailing the technical aspects of this procedure. Patients and methods: We retrospectively reviewed data from patients with HD who underwent pull-through surgery at our Institution between January 2015 and July 2025. Results: Sixty-five patients with HD were included. Fifty-four patients underwent conventional procedures performed at our Center: two open Soave endorectal pull-through (ERPT), forty-four laparoscopic Soave-Georgeson ERPT, and eight Totally Robotic Soave ERPT with limited transanal endorectal dissection. Beginning in 2023, eleven patients underwent a robot-assisted Restorative Proctocolectomy with minimal transanal endorectal dissection. Conclusion: The advantages of robotic technology allow for safer performance of pelvic and particularly rectal surgery. Based on our experience, we suggest that in selected patients with HD, Restorative Proctocolectomy with minimal transanal endorectal dissection can be safely performed using robotic assistance in Centers with advanced minimally invasive expertise in HD management.
Summary
Keywords
Hirschsprung's disease, minimally invasive surgery, proctocolectomy, Pull-through, Rectal dissection, Robot-assisted, robotic
Received
07 December 2025
Accepted
19 February 2026
Copyright
© 2026 Faticato, Reali, Wong, Avanzini and MATTIOLI. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Serena Reali
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.