Abdominal-perineal resection of the aganglionic rectum and colon by the technique described by Swenson1 in 1948 is the standard operation for the definitive surgical treatment of Hirschsprung's disease. Swenson emphasized that this is a "difficult operation that must be performed with careful attention to detail to assure satisfactory results."2 The operation is difficult, long, and may result in serious operative complications. The morbidity and the mortality of the procedure are apparently related to removal of the rectum and the retroperitoneal suture line.
Modifications of Swenson's procedure have been sought. Hiatt's intussusception3 procedure was designed to avoid intra-abdominal contamination. Later, State4 suggested radical anterior resection of the left colon and proximal transverse colon leaving the rectum largely untouched, the anastomosis being just at the peritoneal reflection of the rectum. In 1959, commenting on the Swenson procedure, Potts5 summed up the situation in advising that "the operation,