The Duhamel procedure is a surgical technique used primarily to treat Hirschsprung's disease, involving a specific type of anastomosis to connect the functioning colon to the rectum.
In detail, the Duhamel procedure, first proposed by Bernard Duhamel in 1956, consists of the following key steps:
- Longitudinal Anastomosis: A longitudinal, side-to-side connection (anastomosis) is created between the posterior wall of the patient's native, aganglionic (lacking nerve cells) rectum and the anterior wall of the recruited, ganglionic (containing nerve cells) proximal colon. This brings the healthy colon closer to the anus.
- End-to-Side Anastomosis: An end-to-side anastomosis is performed connecting the posterior wall of the ganglionic colon to the rectum.
Key aspects of the Duhamel procedure:
- It aims to bypass the aganglionic segment of the colon, allowing for normal bowel function.
- It creates a reservoir using both the rectum and the pulled-through colon.
- Modifications to the original procedure have been developed over time to improve outcomes and reduce complications.
Why is this procedure performed?
Hirschsprung's disease is a congenital condition where nerve cells (ganglion cells) are absent in a portion of the large intestine, preventing normal peristalsis (muscle contractions that move stool). This leads to a functional obstruction. The Duhamel procedure aims to remove or bypass the affected segment, allowing for normal bowel movements.
In summary, the Duhamel procedure is a surgical method for treating Hirschsprung's disease that involves creating a connection between the functioning colon and the rectum to bypass the aganglionic segment.
