目的　运用腹腔镜及超声刀技术对不能用经肛门拖出术式的小儿长段型巨结肠病例施行根治手术 ,充分发挥腹腔镜的微创手术优点 ,探讨其操作方法和特点。方法　对 2 0 0 0年 6月至2 0 0 1年 11月收治的 8例长段型先天性巨结肠患儿 ,使用腹腔镜及超声刀技术施行升结肠逆时针翻转拖出 (Deloyers法 )的先天性巨结肠根治术 (改良Soave术 )。观察手术过程、术中出血、术后合并症的出现、大便排出等情况。术后门诊随访。结果　 8例手术均获成功 ,手术时间 190～ 2 40min ,平均2 18min。手术出血最多 1例为 2 0ml,余均少于 5ml,无术后继发性出血 ,无术中和术后早期并发症。8例术后均在门诊复诊 ,随访 3～ 2 0个月 ,所有患儿每日排便 1～ 8次 ,无大便失禁或污粪。 5例术后3个月大便稀糊状 ,半年后转成形大便。结论　应用腹腔镜超声刀技术可有效地施行升结肠拖出手术治疗长段型巨结肠 ,手术可弥补经肛门拖出手术和开腹手术的不足 ,近期效果良好 Objective To apply laparoscopic and ultrasonic knife technique to radical surgery in pediatric long-segment Hirschsprung disease, which can not be traced by the anus and give full play to the advantages of laparoscopic minimally invasive surgery to explore its operation method and characteristics. Methods Eight children with Hirschsprung’s disease who were treated in June 2000 to November 2001 were treated with Deloyers method by laparoscopy and ultrasonic knife technique. Hirschsprung’s disease (modified Soave technique). Observation of surgical procedures, intraoperative bleeding, postoperative complications, stool discharge and so on. Postoperative clinic follow-up. Results All the 8 surgeries were successful. The operative time ranged from 190 to 240 minutes (average 2 18 minutes). A maximum of 1 case of surgical bleeding 20ml, remaining less than 5ml, no postoperative hemorrhage, no early postoperative complications. All 8 patients were in the clinic for follow-up. The patients were followed up for 3 to 20 months. All patients were defecated 1 to 8 times a day without incontinence or excrement. Five cases of stool thin stool after 3 months, six months after the transfer into the shape of stool. Conclusion The application of laparoscopic ultrasonic knife technology can effectively perform the ascending colon pull out operation for the treatment of long segment megacolon, operation can make up for the lack of transanal pull operation and laparotomy, the recent good results