MRI Guided Surgery for Children with Imperforate Anus

For children with imperforate anus, in addition to the challenge of the colon not reaching the skin to form an anus, there is often a deficiency of pelvic muscles which are needed for future continence. 

The Pediatric Colorectal Surgery Program at C.S. Mott Children’s Hospital is one of only two programs in the world to offer the surgical treatment of imperforate anus using MRI surgical guidance during the surgical procedure. 

 

What advantage does MRI surgical guidance offer?

Current minimally invasive or laparoscopic surgical techniques do not allow for the accurate placement of the new anal rectal canal into the most optimal position to make use of as many of the pelvic muscles as possible. 

While open surgeries (PSARP) for imperforate anus allow accurate placement of the rectum, open surgical procedures require a large incision and a complete division of the sphincter complex, potentially weakening the already limited muscle that is present. 

MRI guided surgery is minimally invasive and offers the most accurate placement of the new anal canal without further weakening the pelvic muscles needed for continence.

 

How is MRI guided surgery for imperforate anus performed?

Children with imperforate anus undergo an initial imaging in our state-of-the-art MRI/OR suite, a specially designed operating room featuring an MRI scanner that moves within the operating room on rails. 

The child’s sphincter complex is carefully mapped using MRI.  During the same procedure, without the patient needing to be moved, the surgeon uses the MRI images to guide a needle precisely through the middle of the sphincter complex.  The surgeons then perform a minimally invasive laparoscopic operation, bringing the rectum through the middle of the sphincter complex using the needle as a guide. This results in the rectum passing accurately through the middle of the curved sphincter complex, giving the patient the advantage of all muscle tissue present in the sphincter complex.

 

Discover the Michigan Difference in pediatric colorectal surgical care.

For more information or to make an appointment, call 1-877-475-MOTT (1-877-475-6688).