Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay -
"Numerous technical tricks have been advocated to reduce RP after laparoscopic-assisted anorectal pull-through (LAARP): colic washout of the distal loop to evacuate meconium and have less distension of the rectum during dissection to reduce the risk of redundancy during dissection [5], limited dissection of the rectosigmoid to have a precise length enough to be brought down without excessive redundancy [5], limited peritoneal pression for laparoscopic exposure after recto-perineal anastomosis to limit tension on the descended colon and application of an anchoring stitch with one absorbable suture to track the rectum to the presacral periosteum after recto-perineal anastomosis [5]. This last trick highlighted by Leung et al. [5] managed to significantly reduce the occurrence of RP and reduce soiling in a large series of LAARP."
"Numerous technical tricks have been advocated to reduce RP after laparoscopic-assisted anorectal pull-through (LAARP): colic washout of the distal loop to evacuate meconium and have less distension of the rectum during dissection to reduce the risk of redundancy during dissection [5], limited dissection of the rectosigmoid to have a precise length enough to be brought down without excessive redundancy [5], limited peritoneal pression for laparoscopic exposure after recto-perineal anastomosis to limit tension on the descended colon and application of an anchoring stitch with one absorbable suture to track the rectum to the presacral periosteum after recto-perineal anastomosis [5]. This last trick highlighted by Leung et al. [5] managed to significantly reduce the occurrence of RP and reduce soiling in a large series of LAARP."