Impact of “Lateralizing” the Sigmoid Colostomy on Port Ergonomics in Laparoscopic Anorectoplasty for High Anorectal Malformations

Prospective study of 203 ARM cases demonstrates that laterally positioning sigmoid colostomy in the abdominal wall significantly improves surgical ergonomics during subsequent laparoscopic anorectoplasty compared to conventional left iliac fossa placement. Benefits include reduced complications, better port access, shorter operative time, and decreased surgeon discomfort.