Pull-Through Surgery
Removing the nerveless bowel and joining healthy bowel to the anus.
What is Pull-Through Surgery?
An operation that removes the segment of bowel without nerve cells and brings healthy bowel down to join the anus, so stool can pass normally.
Hospital stay
About a week.
Performed by
Dr. Pratheep Samraj
- Normal
- The problem
- Healthy for comparison
Why It Is Done
Surgery is advised in these situations. The decision is always made after examining your child, never from a description.
- Hirschsprung disease has been confirmed on rectal biopsy
- Washouts cannot be continued indefinitely — they are a bridge to this operation
- Urgently, usually with a stoma first, if the child has enterocolitis or obstruction
Before the Day
- Rectal washouts to decompress the bowel, which parents are taught to do at home
- A contrast enema and biopsy define the level
- Nutrition is optimised and the baby is grown where possible
During the Operation
- General anaesthetic
- The nerveless segment is removed and healthy bowel joined to the anal canal
- Often laparoscopically assisted, or performed through the anus
- Sometimes staged, with a temporary stoma, if the child is unwell or the bowel very dilated
Afterwards, and at Home
- About a week in hospital, longer if a stoma was formed
- Stools are frequent and loose at first — this is expected
- Careful barrier care of the skin around the anus matters a great deal
- Bowel habit improves gradually over months
What Can Go Wrong
- Enterocolitis, which can occur before or after surgery and is treated as an emergency
- Narrowing at the join, needing dilatation
- Soiling or constipation persisting, needing a bowel management programme
- Leak from the join in the early period
Every operation carries risk. These are listed openly because a parent consenting to surgery is entitled to know them — not because they are expected. The surgeon will go through which of them actually apply to your child.
Common Questions
If your question is not here, send it on WhatsApp and the hospital team will answer.
Dr. Pratheep Samraj
Consultant Paediatric & Neonatal Surgeon · Palliyadi, Kanyakumari
Super-specialist surgical care for newborns, infants and children, with expertise in paediatric urology, congenital anomalies, gastro-intestinal surgery and minimally invasive surgery.
Related Pages
Hirschsprung Disease
Missing nerve cells in the bowel cause severe constipation from birth.
ConditionPSARP — Anorectal Malformation Repair
Creating an anal opening in the correct position, within the muscles.
ProcedureConstipation in Children
Common, treatable — but sometimes a sign of something else.
ConditionHirschsprung is curable by surgery, and most children end up continent.
Washouts come first to decompress the bowel, then the nerveless segment is removed and healthy bowel joined to the anus. Bring the biopsy report and the contrast enema films.
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