الفهرس 
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Abstract
This study was conducted at Pediatric Surgery unit in surgical department at Minia University Hospital during period from September 2016 to June 2018.
This study included 40 children suffering from Hirschsprung’s disease (congenital aganglionosis), and in all cases, diagnosis was confirmed by rectal biopsy that showed absent ganglion cells. This study was divided into two groups
Group1: included 20 cases managed by laparoscopic assisted endorectal pull through technique
Group2: included 20 cases managed by transanal approach.
The age of the patients in this study at time of operation ranged between 10 months to 60 months with the mean age 35 months the male to female ratio was 9:1.
The difference in gender was due to case selection.
Barium enema was done in all cases and was conclusive for transitional zone in all cases.
Laparoscope was used in these cases for intra-abdominal mobilization of the colon and for marking the proper site for colonic resection to facilitate the endorectal pull-through procedure.
from this study, the benefits of laparoscopy in management of HSD were :
1. In diagnosis: either by visualizing the affect aganglionic segement or by taking multiple biopsies without the need for large incision.
2. Assisting the endorectal pullthrough with shorter operative time.
3. Accurately evaluating the optimal site for colonic resection and proper site for colo-anal anastmosis.
4. Reduced postoperative pain.
5. Shorter postoperative hospital stay.
6. Smoother postoperative convalescence with early return to normal daily physical activity.
The early results seems very favorable compared to the trans anal approach but we recommend to continue this study for longer period of follow up and larger number of cases to achieve more accurate results about the role of laparoscope in diagnosis and management of HSD.