Modified Duhamel procedure for treatment of Hirschsprung's disease in infancy and childhood: review of 41 consecutive cases.

The original Duhamel procedure has undergone several important modifications over the years by Martin, Ravitch, Soper, Talbert, and others. Combining the best features of these various modifications, a modified Duhamel procedure has been developed and utilized in 41 consecutive infants and children with all types of Hirschsprung's disease, including three with long segment involvement. The procedure includes the use of a formal upper and lower anastomosis and division of the spur by the GIA stapling device. There were no deaths and no early complications. At 2-7 yr all children are toilet-trained, continent, and growing well. With appropriate modifications, the Duhamel operation is a very satisfactory definitive procedure for Hirschsprung's disease in infancy and childhood.