Pull-through Operation Third Step (Hirschsprung´s Disease)

obst_25a_n.jpg: Pull-through operation, third step. The operating field shows the left lower abdomen and the pull-through instrument within the aganglionic intestine. Following pull-through of the rectum including the transitional zone in front of the anus the residual sigmoid and the lower descendant colon run vertically to the pelvis and anus. obst_25b_n.jpg: View from the bottom to the buttocks. Pull-through instrument with the pulled-through rectum and the overlying evaginated anal channel. Both already mentioned structures are divided obliquely near the anocutaneous line, and both wound edges are anastomosed. The anastomosis is pushed back into the anal channel. At no time during surgery intestinal germs are in contact with the abdomial cavity and the extraperitoneal pelvic space, which prevents posteroperative wound infections.