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Pyloromyotomy through circumumbilical incision
K I Ali Gharaibeh1, F Ammari, G Qasaimeh
1Faculty of Medicine, Jordan University of Science and Technology, Irbid.
Insights
Ramstedt
Area of Science:
- Pediatric Surgery
- Surgical Oncology
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) requires surgical intervention.
- Ramstedt's pyloromyotomy is a standard treatment for IHPS.
- The choice of incision impacts surgical outcomes and cosmesis.
Purpose of the Study:
- To evaluate the efficacy and safety of the circumumbilical incision for Ramstedt's pyloromyotomy in infants.
- To assess postoperative complications and cosmetic results associated with this surgical approach.
Main Methods:
- Ramstedt's pyloromyotomy was performed on 22 infants with IHPS.
- A circumumbilical incision was utilized for all procedures.
- Patients were followed for 2 months to 4 years to evaluate outcomes.
Main Results:
- The circumumbilical incision provided adequate access for pylorus delivery without difficulty.
- Postoperative complications included wound infection (3 patients), wound dehiscence (1 patient), and stitch sinus (1 patient).
- No incisional hernias were observed during the follow-up period, and scars were generally neat.
Conclusions:
- The circumumbilical incision is a cosmetic option for Ramstedt's pyloromyotomy in IHPS.
- It offers comparable surgical access to other incisions with a low rate of significant morbidity.
- This approach is a viable and aesthetically pleasing surgical technique for pediatric patients.
Abstract:
Twenty-two infants suffering from infantile hypertrophic pyloric stenosis underwent Ramstedt's pyloromyotomy using circumumbilical incision. There was no difficulty in delivering the pylorus out of the incision. Three patients developed wound infection, one patient developed wound dehiscence at the fascial plane and one patient developed stitch sinus. No incisional hernias were noted after a follow-up period ranging from 2 months to 4 years (mean 27 months). All scars were neat except that of the patient who developed wound dehiscence at the fascial plane and another who developed stitch sinus. This incision is cosmetic and gives access that is almost comparable to other incisions without a significant increase in the morbidity rate.