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Retrorectal pull-through

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This operation for Hirschsprung's disease entails pulling down ganglionic bowel behind the lower aganglionic segment but within the sling of the puborectalis muscle. The rectum is divided near the peritoneal reflection, and the retrorectal space is opened to below the pelvic floor. An incision in the posterior half of the anal canal at the level of the dentate line allows the proximal ganglionic bowel to be pulled thorough and sutured to the posterior half of the anal canal opening. A common lumen is thus created to connect the anus and ganglionic bowel.


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