Sequential Track and Intestinal Gathering (“STRING”): A Novel Technique for Multiple Intestinal Biopsies

Background: Intestinal biopsies are essential for the diagnosis and treatment of Hirschsprung’s disease and visceral myopathies. However, intraoperative sampling may be inconclusive, leading to diagnostic errors and unnecessary extensive resections. Current laparoscopic approaches remain technically demanding. The aim of this study is to present an unpublished, safe, and effective technique, Sequential Track and Intestinal Gathering (STRING), to perform multiple laparoscopic intestinal biopsies and ensure diagnostic accuracy in pediatric patients. Methods: Retrospective observational descriptive study. All patients underwent a new minimally invasive intestinal biopsy technique for suspected visceral myopathy or Hirschsprung’s disease. Age, sex, operative time, complications, number of biopsies, and final diagnosis were analyzed. Results: Thirteen patients were biopsied (10 male, 3 female) with a median age of 9 months (IQR: 5–7) and median weight of 7 kg (IQR: 6–8.4). Total operative time was 57 minutes (IQR: 35–75). Oral tolerance was restored at 28 hours postoperative (IQR: 12–24), and hospitalization time was 47 hours (IQR: 24–54). 3.8 biopsies per patient were done; all samples were conclusive, nine Hirschsprung’s disease, three visceral myopathy, and one ganglionar. No complications were reported. Conclusion: The STRING technique appears to be safe, effective, and reproducible. It allows multiple intestinal biopsies through a single minimally invasive approach with conclusive results.