Minimally Invasive Surgery

Imperforate Anus

Signs and Symptoms
Diagnosis
Treatment

Treatment

If the anus did not develop correctly, surgery will be performed to create an opening, or new anus, to allow stool to pass. Treatment may differ, depending on if the imperforate anus is high or low in the pelvis.

If the intestine ends high in the pelvis, treatment usually involves three procedures:

• First a stoma, or opening of the intestine to the abdomen, is made in a procedure called a colostomy. Newborns who have a stoma will need a special stoma bag on the abdomen to collect stool.

• The second procedure, called anoplasty, involves pulling down the rectum to the anus where a new anal opening is created. If a fistula or abnormal connection to the bladder or vagina is present, that connection will be closed.

• Several months later after the new anal opening has healed, a third procedure will be performed to close the stoma.

If the intestine ends low in the pelvis, an anal opening often can be made in a single operation. The rectum is pulled down to the anus and a new anal opening created, using a minimally invasive technique called laparoscopy. In these cases, a stoma is not required. If the anal opening is in the wrong position, it will be closed and moved to the correct location.

Following the operation, babies have very frequent bowel movements that can cause severe diaper rash. A protective skin cream is used immediately after surgery.

Babies can go home once they are drinking, having bowel movements, feeling comfortable on pain medication and are free of fever.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated January 15, 2008