Leading Providers of Hirschsprung Disease Treatment, 2025

Matthew A. Love President & CEO

Nicklaus Children’s

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Patients don’t care how much you know until they know how much you care.

Editor’s Note

Nurturing Hope in Hirschsprung

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ne of the complex diseases in healthcare, Hirschsprung causes substantial difficulties for both affected infants and their families because the condition develops when essential nerve cells disappear from colon regions. Our latest edition, ‘Leading Providers of Hirschsprung Disease Treatment, 2025’ demonstrates how prompt and successful medical care directly affects children suffering from this disease.

The issue features top healthcare organizations that excel in Hirschsprung Disease diagnosis and treatment protocols.

The medical facilities provide advanced surgical treatment including pull-through surgeries along with innovative minimally invasive surgical procedures while focusing on complete patient care. Treatment of Hirschsprung Disease requires more than surgical interventions because it requires extensive support for patients alongside their families from diagnosis until the completion of treatment.

advanced imaging techniques for precise patient diagnosis.

The providers demonstrate pediatric specialization through custom treatment approaches which focus on individual child requirements. The medical facilities emphasize providing emotional care as well as educational services to help families comprehend the complexities of Hirschsprung Disease treatment.

This edition helps readers develop a better comprehension of Hirschsprung Disease by presenting information which emphasizes the significance of empathetic medical care. It highlights the work of the leading healthcare providers who demonstrate their absolute dedication to excellence in treating children with Hirschsprung Disease.

Have an enlightening read!

The featured providers maintain their dedication to use modern diagnostic tools which include rectal biopsy and

Nalie May Natalie May

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Cover Story

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Nicklaus Children's Where Your Child Ma ers Most

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Profile

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Mercy Medical Angels The Lifeline Between Pa ents and Treatment

Articles

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Dis nguishing Hirschsprung Disease Symptoms from Other Gastrointes nal Disorders

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Surgical Advances in Hirschsprung's Disease Treatment and Post-opera ve Management

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LEADING PROVIDERS OF HIRSCHSPRUNG DISEASE TREATMENT 2025 Organiza on

Featuring Person

Brief

Akron Children's Hospital akronchildrens.org

Christopher Gessner President & CEO

Akron Children's Hospital offers comprehensive pediatric care with a commitment to family-centered services, advanced treatments, and community outreach, ensuring every child receives the best possible health care.

Children's Hospital Los Angeles chla.org

Paul Viviano President & CEO

Children's Hospital Los Angeles is a top-ranked pediatric facility, providing specialized care for children, teens, and young adults, focused on family-centered treatment and innova ve research.

Har ord Hospital har ordhospital.org

Cheryl Ficara COO

Har ord Hospital is a leading medical center providing a wide range of healthcare services, including specialized care in pediatrics, with a focus on pa ent-centered approaches and community health ini a ves.

Mercy Medical Angels mercymedical.org

James Godwin President & CEO

Mercy Medical Angels provides free transporta on to medical care for pa ents in need, ensuring access to essen al healthcare through volunteer pilots and ground transport services.

Nicklaus Children's Health System nicklaushealth.org

Ma hew A. Love President & CEO

Nicklaus Children's Health System is dedicated to providing specialized, compassionate healthcare exclusively for children, ensuring a nurturing environment for healing and lifelong health.

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Nicklaus Children’s Where Your Child Matters Most

We are dedicated to providing the best care to every child. It’s a mission that inspires everything we do.

Matthew A. Love President & CEO

Nicklaus Children’s

Leading Providers of Hirschsprung Disease Treatment, 2025

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hildren are the heart and soul of the family. And healthcare plays a very important role in society, especially when it is about children. Being the most high-at-risk members, children need specialized care that goes beyond medical treatment. It’s about creating an environment where they can heal, grow, and thrive.

Globally, hospitals and healthcare professionals are rising to address this challenge. They are utilizing advanced technologies, enhancing patient experiences, and actively striving to guarantee every child has an opportunity for a healthy future. One of the leaders in this essential sector is Nicklaus Children’s Health System, an institution with a 75-year history as the only specialty licensed hospital exclusively for children serving families in South Florida and beyond.

Matthew A. Love, the President and CEO of Nicklaus Children’s Health System, plays a central role in the health system’s growth and success. Joining the organization in 2018 as Chief Financial Officer, Matthew quickly rose to the role of CEO, just as the world was thrown into the chaos of the COVID-19 pandemic. His leadership, with a unique combination of finance and healthcare experience, has guided the health system through both challenges and victories. “I never imagined the health system would face such a global challenge, but we adapted, and I’ve learned so much along the way,” Matthew says. Led by his guidance, the health system continues to raise the standards of what pediatric healthcare can achieve, ensuring that the most advanced care is available to children when they need it most.

Nicklaus Children’s Hospital, the health system’s flagship hospital based in South Florida, is a shining example of what pediatric healthcare can be. Over the past 75 years, it has grown from its humble beginnings into a nationally recognized center of excellence, providing specialized care to children not only from the local community but from across the U.S. and even Latin America and the Caribbean.

The hospital in Miami is supported by a network of over 30 outpatient affiliates that span four counties as well as several locations. Matthew emphasizes that the health system’s mission is not just to serve those who walk through its doors, but to ensure that every child receives the care they deserve. “We are dedicated to providing the best care to every child. It’s a mission that inspires everything we do here,” he says. With this dedication to care, the health system has seen tremendous growth, expanding its services to meet the needs of a growing population in Miami-Dade County and beyond.

Let’s read on to know how Nicklaus Children’s is shaping the future of pediatric healthcare through growth, innovation, and leadership!

Meeting the Demands of a Growing Community Nicklaus Children’s Hospital has always understood that growth is essential in healthcare. As the population of Miami-Dade County swells, so does the demand for specialized pediatric care. “When the hospital was founded in 1950, Miami-Dade had fewer than 500,000 people. Now, it’s a bustling county with almost 2.7 million residents. Our mission of serving every child means we have to grow to meet those needs,” explains Matthew. And that’s exactly what the hospital has done. With rapid population growth in South Florida, it is no surprise that Nicklaus Children’s has steadily expanded its services, ensuring that families don’t have to travel long distances for world-class care.

“The number one priority for us is to ensure that the families we serve have access to the best care, no matter where they are,” Matthew shares. With its comprehensive approach to pediatric care, the health system now offers specialized services for a wide range of medical conditions.

Whether children are facing routine treatments or complex surgeries, they can receive care from highly trained specialists close to home. This commitment to comprehensive care has made the hospital a critical resource for families throughout the region and beyond.

The health system’s expansion isn’t just a response to numbers—it’s a direct reflection of its mission to serve every child in the community. As more families from diverse backgrounds seek care, the health system continues to broaden its specialties. “Our goal is to ensure that no matter where you live in South Florida, you can access the care your child needs,” Matthew explains. Over the years, Nicklaus Children’s has expanded its reach, now seeing patients from not only all corners of Florida but also from across the U.S. and international regions like Latin America and the Caribbean.

Expanding Access to Pediatric Care An important part of Nicklaus Children’s growth strategy is the establishment of partnerships. By collaborating with other healthcare institutions, the health system has been able to increase access to its services. One notable collaboration is with Baptist Health of South Florida, which has helped extend pediatric emergency care options for

We announced this affiliation last year, which will allow us to care for even more children, expanding our growing footprint in Broward County.

families throughout the region. “Years ago, when we first partnered with Baptist Health, and it has been instrumental in enhancing healthcare delivery for children,” says Matthew. Through this collaboration, the health system has been able to share resources and expertise, benefiting a greater number of children and families in the area.

More recently, Nicklaus Children’s announced an affiliation with Broward Health, another critical step toward expanding access. “We announced this affiliation last year, which will allow us to care for even more children, expanding our growing footprint in Broward County,” Matthew explains. For families in Broward, this partnership means they will receive high-quality, specialized pediatric inpatient care at local facilities, without needing to travel all the way to Miami. “It’s about convenience and access to care that meets the highest standards,” Matthew continues.

This is just one example of how the health system is working to provide care where it’s needed most, ensuring that families don’t have to go far to get the best possible treatment for their children.

These partnerships, along with the hospital’s constant focus on improving operational efficiencies, have helped Nicklaus Children’s navigate the challenges posed by the pandemic.

Matthew speaks with pride about how the hospital has increased its operational efficiency in recent years. “Our emergency department went through a complete transformation. We’ve improved patient flow, cut wait times, and improved patient satisfaction, all while maintaining the highest standards of care,” he says. These efforts are part of a broader strategy to not only serve more families but to do so in a way that improves the experience for every patient who walks through the door.

The Griffin Surgical Tower One of the most significant strides in Nicklaus Children’s commitment to growth and excellence is the introduction of the Kenneth C. Griffin Surgical Tower. It is a revolutionary, five-story, 131,000-square-foot facility designed to elevate the standard of pediatric surgical care. This advanced facility, opened to much fanfare, features 12 fully integrated operating rooms equipped with the latest surgical technologies. “A few years ago, we recognized that our existing operating rooms needed to transform to meet the needs of a growing pediatric hospital,” Matthew explains.

The new surgical tower represents a leap forward in terms of both patient care and the patient experience.

like personalized medicine, gene therapy, and pediatric oncology are all moving rapidly. We’re excited to see where these innovations will take us.”

The Griffin Surgical Tower is not just about providing more space for surgeries—it's about creating an environment that enhances the healing process for children.

The Griffin Surgical Tower is not just about providing more space for surgeries—it’s about creating an environment that enhances the healing process for children. “It’s designed to be child-friendly. We’ve incorporated features like virtual reality tools to reduce anxiety before surgery, and an advanced texting platform to keep families updated in real time,” Matthew shares. These thoughtful touches are part of the hospital’s commitment to ensuring that children and their families feel supported throughout their entire healthcare journey.

In terms of cutting-edge medical technology, the Griffin Surgical Tower is a game changer. It is equipped with some of the latest innovations in pediatric surgery, including advanced imaging systems like the O-Arm and the Zeiss® robotic visualization system. These tools allow surgeons to perform delicate and complex procedures with greater precision and confidence. “We’re investing in the best tools available, so our surgeons can perform the most advanced procedures with the highest level of accuracy,” Matthew says. This focus on technology is coupled with a strong commitment to compassion, making every procedure as smooth and comfortable as possible for the child and their family.

Shaping the Future of Pediatric Healthcare As Nicklaus Children’s looks toward the future, the horizon is filled with exciting possibilities. While the healthcare landscape faces its challenges, including staffing shortages, financial constraints, and healthcare disparities, Matthew remains steadfast in his optimism. “The future of pediatric care is incredibly promising,” he says. “Advances in fields

Matthew believes that the health system’s commitment to staying on the leading edge of technology will play a crucial role in its success. “We will continue to focus on integrating the best technologies into our patient care,” he assures. “Whether it’s virtual reality, robotics, or tools we haven’t even thought of yet, our mission remains the same: to provide the best care to every child.” Nicklaus Children’s dedication to excellence means that the health system will never stop innovating, always ensuring that the most advanced medical treatments are available to those who need them.

At the same time, Matthew stresses the importance of addressing the human aspect of healthcare—especially in pediatric care. “Technology can only go so far. What truly sets us apart is the compassionate, family-centered care we provide. We never forget that the patient is a child, and the family is at the heart of the healing process.” This balanced approach ensures that the health system remains both a leader in innovation and a place where children and families feel cared for, understood, and supported.

Nicklaus Children’s Health System is more than just a healthcare facility—it’s a place of hope, innovation, and healing. With its focus on growth, strategic partnerships, and the integration of new technologies, it will remain a pillar of excellence in pediatric care for generations to come. As the health system continues to evolve, it will stay true to its mission of providing the best possible care to every child, no matter where they live or what their needs may be. The future of pediatric healthcare is bright, and with leaders like Matthew at the helm, Nicklaus Children’s will continue to shape that future for years to come.

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Distinguishing

Hirschsprung

Disease Symptoms

from Other

Gastrointestinal Disorders February 2025

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irschsprung's disease is a congenital condition characterized by the absence of nerve cells called ganglion cells in parts of the large intestine, or colon, which may cause difficulty passing stool. Being able to identify Hirschsprung Disease Symptoms early is vital because the disease can cause extreme constipation or intestinal blockage. Some of the symptoms can be similar to other GI conditions, but this understanding can allow for early diagnosis and intervention.

Understanding Hirschsprung Disease The condition results from improper formation of the enteric nerves during embryonic development. The enteric nerves initiate muscle contractions that facilitate stool movement within the intestine. Absence of such contractions will result in an accumulation of stool, with varied symptoms resulting. The extent of Hirschsprung Disease Symptoms depends on the length of the affected segment. In some cases, the intestinal segment involved is very short and may not appear for months or even years.

Common Hirschsprung Disease Symptoms Hirschsprung's disease varies symptoms based on age. In some cases, new-born babies may have it; others develop this disease later on in infancy, childhood, and even in adults.

In Newborns Failure to have a bowel movement within the first 48 hours of life. Swollen abdomen (belly). Vomiting green or brown substances. Problems feeding.

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Explosive stools or diarrhea after a rectal exam.

Symptoms in Older Infants and Children: •

Chronic constipation that does not improve with standard treatments.

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Abdomen is swollen.

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Failure to thrive, meaning they do not gain weight.

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Diarrhea.

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Symptoms of Hirschsprung-associated enterocolitis, which include diarrhea.

In some cases, Hirschsprung Disease Symptoms are mild and may not be diagnosed until later in childhood or adulthood. Adults typically have a history of abdominal swelling and chronic constipation that doesn't respond to oral laxatives.

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Differentiating Hirschsprung Disease from Other GI Disorders

Diagnostic Approaches Diagnosis of Hirschsprung's disease depends on clinical examination and diagnostic testing.

It is challenging to make an accurate diagnostic assessment because various gastrointestinal disorders share overlapping symptoms with Hirschsprung's disease.

1. Young children often experience functional constipation which describes their rare bowel movements when they lack physical or structural abnormalities in their digestive system. Functional constipation differs from Hirschsprung's because it does not include absent nerve cells in the colon.

Patients with this condition experience three major symptoms including straining when passing stool and both hard stools and abdominal pain. Chronic constipation exists as a Hirschsprung's symptom yet newborns who fail to pass their first stool serve as the defining indicator for the condition.

2. The primary cause of intestinal blockage originates from hernias combined with adhesions along with intussusception. The same symptoms of abdominal pain plus vomiting and bloating exist in both medical conditions.

The cause for Hirschsprung's differs from other obstructions because Hirschsprung's results from missing nerve cells while other obstructions form from physical blockages.

Rectal Biopsy: Rectal biopsy is the gold standard diagnosis for Hirschsprung's disease. A small tissue sample is taken from the rectum for checking the presence of ganglion cells. The absence of these cells establishes the diagnosis.

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Anorectal Manometry: The manometry determines rectal pressure in addition to anorectal function.

Pressure that is outside a normal range suggests abnormal reflexive activity; abnormal reflex activity related to the lack of neurons associated with Hirschsprung's disease could present.

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Barium Enema: With a barium enema, barium injection into the rectum results in X-rays with visualization of the colon; hence, narrowed bowel segments appear evident, typically typical of the problem in question as Hirschsprung's.

Early diagnosis and treatment of Hirschsprung's disease will help avoid the complications that come with enterocolitis and toxic megacolon. Enterocolitis is inflammation of the intestine and is considered lifethreatening and must be seen to by a medical professional at once. It usually requires surgical intervention in which the portion of the colon involved is removed or bypassed. After surgery, most children have normal bowel movements.

3. Irritable Bowel Syndrome constitutes a long-lasting intestinal disorder that affects the large intestine through symptoms such as abdominal discomfort along with gas build-up and diarrhea and constipation issues. Although IBS occasionally leads to constipation it does not get diagnosed at birth nor does it exhibit the defining characteristic of absent ganglion cells.

Conclusion The symptoms may mimic those of other GI diseases; therefore, diagnosis must be both prompt and accurate.

Constipation, vomiting, and abdominal distension are some common features in various GI diseases, but failure to pass the first stool after birth is an important symptom for Hirschsprung's disease. The rectal biopsy, anorectal manometry, and barium enema help in diagnosing the condition. Early intervention through surgery will improve the prognosis and prevent potential life-threatening complications. Health providers must maintain a high index of suspicion and thoroughly evaluate to rule out other gastrointestinal disorders to allow timely and appropriate management of patients with Hirschsprung Disease Symptoms. Knowledge of Hirschsprung Disease Symptoms and swift action will immensely improve the quality of life in such individuals.

4. Celiac Disease functions as an autoimmune illness because ingesting gluten causes damage to the small intestine. These patients experience diarrhea along with abdominal discomfort and stomach bloating and they show signs of poor growth. The diagnostic markers for celiac disease include gluten sensitivity together with specific blood test results but failure to thrive represents an overlapping symptom with Hirschsprung Disease Symptoms.

5. Chronic Intestinal Pseudo-Obstruction (CIPO) functions as a severe motility disorder that creates clinical and radiologic blockage symptoms although physical blockage remains undetectable. Abdominal pain together with distension and vomiting accompany the symptoms while constipation remains present. A proper assessment of intestinal motility and nerve function serves as the sole method to differentiate between CIPO and Hirschsprung's disease.

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Rear Admiral (Ret) JB Godwin III President and CEO

Mercy Medical Angels

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Leading Providers of Hirschsprung Disease Treatment, 2025

Mercy Medical Angels The Lifeline Between Patients and Treatment

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obvious and was the basis for establishing this critical service. In 1987 WAM was redesignated Mercy Medical Airlift (MMA) and located its headquarters in Manassas, VA. Due to costs, flight operations were relocated to Virginia Beach and in the 1997 timeframe and MMA headquarters was eventually relocated as well. Patient Flights flown were designated as Angel Flights. MMA is the umbrella organization for Angel Flight Mid-Atlantic, Angel Wheels, Angel Wings for Veterans, and Angel Canines and Wounded Warriors. In 2000, with the national need being recognized, linking flights across America was essential so Angel Flight America was created with five regional partners. This was later redesignated Air Chairty Network.

There is a book published in 2008 called “Angel Flight Mid-Atlantic” which chronicles this history in both words and pictures.

n modern medicine, cutting-edge treatments and sophisticated technologies frequently make the news.

However, for numerous patients across America, the primary barrier to transformative care isn’t medical complexity; it’s simply getting to the doctor’s office. This is the moment when Mercy Medical Angels step in, turning what seems unachievable into a reality for thousands annually.

What started as a modest aviation ministry has transformed into a national lifeline for patients encountering severe transportation difficulties. With James Godwin at the helm as President and CEO, Mercy Medical Angels has redefined the idea of delivering access to healthcare.

These committed individuals do more than provide rides; they deliver hope via a network of volunteer pilots, commercial airlines, ground transport, and gas cards. Their influence is significant—connecting patients with the essential care they urgently require, frequently after all other alternatives have been tried.

As the nation’s leading charitable medical transport provider, could you describe the range of transportation services you offer and the typical number of patients you assist annually?

MMA provides volunteer pilots (Angel Flight Mid-Atlantic) who use their own aircraft, time and money on private aircraft, Commercial airlines, Bus, Train, Gas cards for patients using their own vehicles and Rideshare (Uber) nation-wide.

What distinguishes Mercy Medical Angels is not only their services but also their dedication to eliminating obstacles to healthcare access. In a system that can frequently seem detached, they provide a personal element—a reminder that empathy and creativity can collaborate to transform lives, one experience at a time.

In Fiscal Year 2024, MMA provided 53,500 missions for approximately 7000 patients. Many of the patients have recurring medical appointments over the entire year, so the mission count is for each trip is tracked.

Let’s delve into the details below!

Can you tell us about the origins of Mercy Medical Angels and how the organization has evolved to become a critical lifeline for patients needing medical transportation?

What are the most significant challenges patients encounter when seeking essential medical care that make your services so crucial?

Mercy Medical Angels was established in 1972 in Washington DC as the Washington Aviation Ministry (WAM) with one aircraft and 4 founders. The need for patient transportation to critical medical treatment was

February 2025

Drs indicate to us that 70% of medical appointments go unmet because the patients don’t have transportation to get there. We step into that gap to fulfil that need at no cost to the patient.

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In Fiscal Year 2024, MMA provided 53,500 missions for approximately 7000 patients.

What technology or innovative approaches has Mercy Medical Angels implemented to improve patient transportation and coordination?

Our application process is handled through a portal that provides the patient the opportunity to request assistance, provide needed documentation of the appointment and need as this is predominantly focused on low-income families.

Our pilot communications portal list patient requests where they have the opportunity to apply for flight legs to get the patient to the final destination.

In Fiscal Year 2025 we will establish a Rideshare program in the Norfolk/VA Beach/Hampton Roads area which will progressively lead to a Nation-Wide Rideshare program in succeeding years further deepening the modes available.

Could you share a powerful patient story that illustrates the life-changing impact of Mercy Medical Angels’ transportation services?

We have a patient named Logan who exemplifies the transformative power of our transportation services. With over 20 round trips through AFMA, his journey represents hope, resilience, and the critical medical access we provide to patients in need.

Describe how your organization collaborates with healthcare providers, veteran organizations, and other nonprofits to identify and support patients requiring medical transportation. Ÿ We work with the Social Workers at critical medical facilities such as MD Anderson, Sloan Kettering, and Cleveland Clinic with many more that could be listed. Ÿ We have established Memorandums of Agreement with The Travis Mills Foundation, Boulder Crest, Heroes and

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Horses, Avalon, Warriors and Heroes Outdoors and more than 40 others. These are focused not only on Veterans but also First Responders. Ÿ We have relationships with other non-profits, but specifically with the US Air Force Aide Society. Ÿ While the standard for non-profits overhead rates recently was changed to a maximum of 20%, MMA has consistently been less than 15% year over year.

What are the primary funding sources for Mercy Medical Angels, and what strategies do you employ to ensure long-term financial sustainability? Ÿ We also have relationships with the Greene Family Foundation and The Perry Family Foundation. Each of these provides financial resources that allow us to fund patient transportation. Ÿ We established an Endowment account in 2022 of $10 Million. That was the goal of our five-year strategic plan, and we met that goal two years early as we have the pledges and grants to meet the goal. Ÿ We have had clean financial audits for the last 4 years, with no material findings, which is the best possible finding. Ÿ We have increased our budget year over year for the last 4 years at an average of 20%.

Looking forward, what are the strategic goals and expansion plans for Mercy Medical Angels in the next five years? Ÿ We established a missions completed growth goal of 20%. Ÿ We have increased Veteran trips by a minimum of 10% or more each of the last 4 years. Ÿ We have not denied any valid trips for more than 3 years. Ÿ We have established a definitive set of metrics for each of our organizational business areas (Development, Operations and Financial) and have consistently met or exceeded those goals for the last 4 years.

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Surgical Advances

Hirschsprung's Disease Treatment and Post-operative Management In

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he absence of nerve cells in the colon's structure constitutes a major surgical challenge that affects pediatric patients. The absence prevents usual intestinal contractions so obstruction occurs and multiple complications result.

Hirschsprung's Disease treatment underwent essential improvements after the first definitive operation by means of revolutionary surgical techniques which enhanced both patient recovery and minimized complications.

Surgical Techniques: From Open to Minimally Invasive The accepted treatment approach for Hirschsprung's Disease consists of removing the affected colon segment before performing pull-through surgery. Through this surgical approach doctors link the healthy colon segment directly to the anus for returning bowel function. Opensurgical pull-through procedures gained major advancements after minimally invasive techniques became available.

Laparoscopic surgery has become widely used for multiple patients because it offers patients various advantages including smaller incisions while minimizing blood loss February 2025

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and providing reduced postoperative pain and shorter recovery periods. Medical experts have developed three types of laparoscopic procedures that include traditional laparoscopy and transumbilical single-hole laparoscopy alongside robotic surgery. The initial procedure results in better appearance while both other methods require less surgical duration than the final approach.

Follow-up Care and Late Results Post-operative care is very much dependent on the optimization of outcomes in children who are undergoing Hirschsprung's Disease Treatment. Though there is no cure for Hirschsprung's disease, surgical treatment often leads to a good outcome. Monitoring for complications such as constipation, soiling, and enterocolitis is critical.

Some medical conditions such as total colonic aganglionosis or unstable child conditions require an ostomy procedure. The surgical creation of an abdomen opening (stoma) allows stool to divert through external bags becomes known as an ostomy. The affected bowel can heal through this procedure prior to the following pull-through operation. The pull-through surgery usually takes place between six months and one year after its initial planning.

Dietary Management Dietary management, such as a highfiber diet and adequate hydration, can regulate bowel movements and prevent constipation.

Bowel Training The child may be taught bowel training programs to establish a regular bowel habit and enhance continence.

Medications Sometimes, stool softeners or laxatives are required to manage constipation. In some cases, antibiotics are used to prevent or treat enterocolitis.

Management of Total Colonic Aganglionosis (TCA) TCA is an advanced variant of Hirschsprung's disease that involves the entire colon and is complex. TCA is a fatal disease in history due to a poor prognosis; this is improved because of surgical advancement and post-surgical care.

The latest surgical technique adopted today is total colectomy combined with endorectal pull-through, and they have a favorable stooling patterns and continence rates.

Long-Term Follow-Up The child should have long-term follow-up with the pediatric surgeon and gastroenterologist for potential complications and optimal bowel function.

Conclusion Important developments in the Hirschsprung's disease treatment are found in both surgical and postoperative care.

The surgical technique has changed much; there is less trauma caused at the time of surgery, by employing minimally invasive techniques like laparoscopy and robotics, thereby easing speedy recovery times. Techniques of managing TCA and HAEC have further improved for these challenging disorders. With proper surgical intervention and overall post-operative care, most children suffering from Hirschsprung's disease can be expected to achieve satisfactory bowel function and quality of life.

Research and innovation are ongoing and promise further refinements in the treatment of Hirschsprung's Disease, thus bettering the lives of affected children and their families.

Managing Hirschsprung's-Associated Enterocolitis (HAEC) Hirschsprung's-associated enterocolitis is a severe and potentially life-threatening complication affecting a significant percentage of patients with Hirschsprung's disease. HAEC is characterized by inflammation and bacterial overgrowth in the colon, leading to fever, abdominal distension, and diarrhea. Prompt recognition and aggressive management are crucial. Treatment strategies include intravenous fluids, broad-spectrum antibiotics, and rectal irrigations. In severe cases, ostomy surgery may be required to divert the fecal stream and allow the inflamed colon to heal.

Redo Pull-through Procedures

-Pearl Shaw

Most patients have resolution of symptoms early after surgery; however, for some, significant long-term morbidity can ensue, and redo pull-through procedures may become necessary. Many of these take the form of endorectal pullthrough, and results seem to be the same as the primary pull-through procedure.

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