{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T15:38:30Z","timestamp":1776872310765,"version":"3.51.2"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":173,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J Pediatr Surg Rep."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>We report the first documented pediatric case of the Deloyers procedure performed using robotic surgery to treat a female patient with long-segment Hirschsprung disease. A 9-month-old child was diagnosed with long-segment Hirschsprung disease. Despite rectal irrigations, the patient experienced refractory constipation and enterocolitis, necessitating exploratory surgery and ileostomy. A transition zone was identified at the proximal transverse colon, with mapping biopsies confirming aganglionosis up to the splenic flexure. At 16 months of age, the child underwent a robot-assisted endorectal pull-through with ileostomy closure. Four 8-mm trocars were placed in the epigastric, left subcostal, right subcostal, and right flank regions. Dissection and mobilization extended distally beyond the peritoneal reflection and proximally to the hepatic flexure, preserving the marginal vascular arcades. The middle and right colic arteries were ligated, while the ileocolic artery was preserved. Indocyanine green fluorescence imaging confirmed adequate vascularization of the hepatic flexure. A counterclockwise 180-degree rotation of the right colon was performed. In the perineal phase, a mucosal incision above the dentate line was followed by progressive mucosectomy to reach the isolated rectum. The colon was pulled through, and a tension-free coloanal anastomosis was performed. The postoperative period was uneventful at the 6-month follow-up. Robot-assisted laparoscopic endorectal pull-through with the Deloyers procedure is a feasible and safe technique for long-segment Hirschsprung disease. Larger case series are required to assess its long-term outcomes and potential advantages. An explanatory video of the surgery is available.<\/jats:p>","DOI":"10.1055\/a-2640-4118","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T19:20:36Z","timestamp":1750706436000},"page":"e14-e18","source":"Crossref","is-referenced-by-count":2,"title":["Robot-Assisted Laparoscopic Endorectal Pull-Through Combined with Deloyers Turnover in Long-Segment Hirschsprung Disease: A Case Report"],"prefix":"10.1055","volume":"13","author":[{"given":"Maria Stella","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Department of APediatric Surgery, IRCCS, Istituto Giannina Gaslini, Genoa, Italy"},{"name":"Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, University of Genoa, Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria G.","family":"Faticato","sequence":"additional","affiliation":[{"name":"Department of APediatric Surgery, IRCCS, Istituto Giannina Gaslini, Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Fanti","sequence":"additional","affiliation":[{"name":"Department of APediatric Surgery, IRCCS, Istituto Giannina Gaslini, Genoa, Italy"},{"name":"Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, University of Genoa, Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela C. Y.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of APediatric Surgery, IRCCS, Istituto Giannina Gaslini, Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Girolamo","family":"Mattioli","sequence":"additional","affiliation":[{"name":"Department of APediatric Surgery, IRCCS, Istituto Giannina Gaslini, Genoa, Italy"},{"name":"Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, University of Genoa, Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s00383-024-05767-0","article-title":"Surgical maneuvers for long-segment Hirschsprung pull-through in unique patients","volume":"40","author":"M Zornoza","year":"2024","journal-title":"Pediatr Surg Int"},{"issue":"02","key":"ref2","first-page":"147","article-title":"[Technic permitting the easy assurance of continuity of the colon & conservation of sphincter after excision of the left transverse hemicolon & entire left colon; possible inclusion of rectum]","volume":"75","author":"L Deloyers","year":"1958","journal-title":"J Chir (Paris)"},{"issue":"12","key":"ref3","first-page":"e75539","article-title":"Colonic Derotation Revisited: The \u201cDeloyers Procedure\u201d for Long-Segment Hirschsprung Disease","volume":"16","author":"I Elhalaby","year":"2024","journal-title":"Cureus"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1089\/lap.2016.0337","article-title":"A provisional experience with robot-assisted Soave procedure for older children with Hirschsprung disease: back to the future?","volume":"27","author":"G Mattioli","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s13023-020-01362-3","article-title":"ERNICA guidelines for the management of rectosigmoid Hirschsprung's disease","volume":"15","author":"K Kyrklund","year":"2020","journal-title":"Orphanet J Rare Dis"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"161565","DOI":"10.1016\/j.jpedsurg.2024.04.019","article-title":"Ernica clinical consensus statements on total colonic and intestinal aganglionosis","volume":"59","author":"A L Granstr\u00f6m","year":"2024","journal-title":"J Pediatr Surg"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1055\/a-2506-6590","article-title":"Advancing pediatric robotic colorectal surgery: trends, outcomes, and future directions-a comprehensive review","volume":"35","author":"A Pini Prato","year":"2025","journal-title":"Eur J Pediatr Surg"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1097\/SLA.0000000000006172","article-title":"Robotic-assisted proctosigmoidectomy vs. laparoscopic-assisted Soave pull-through for Hirschsprung's disease: medium-term outcomes from a prospective multicenter study","volume":"281","author":"M Zhang","year":"2025","journal-title":"Ann Surg"},{"key":"ref9","first-page":"E302","volume-title":"Robotic-Assisted Deloyers Procedure","author":"L A Devane","year":"2023"}],"container-title":["European Journal of Pediatric Surgery Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2640-4118.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T01:35:17Z","timestamp":1752284117000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2640-4118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":9,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2025,3,18]]},"published-print":{"date-parts":[[2025,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2640-4118","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2194-7619","2194-7627"],"issn-type":[{"value":"2194-7619","type":"print"},{"value":"2194-7627","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6,23]]},"published":{"date-parts":[[2025,1]]}}}