The squeeze technique to assist transumbilical delivery of pyloric tumor

The popularity of the transumbilical approach for the treatment of infantile hypertrophic pyloric stenosis has increased over recent years mainly because of its superior cosmetic result. However, delivering a large pyloric tumor through a small incision can be technically demanding and is associated with significant complications. Described in this article is a novel yet simple technique to facilitate delivery of the pyloric tumor.

This is a prospective report of an 8-year experience of a single surgeon on consecutive patients with pyloric stenosis who underwent transumbilical pyloromyotomy assisted by the squeeze technique. Information on patient demographics, perioperative performance, and postoperative stay were recorded and analyzed. A standard surgical approach and postoperative feeding regimen were used in all cases.

Forty-six patients were operated on at a mean of 5.5 weeks and discharged 2.5 days postsurgery. There were no significant intra- or postoperative complications, and all patients were reviewed at 6 weeks postdischarge.

The success of the squeeze technique in facilitating delivery of the pylorus strengthens the case for the continued use of the transumbilical over traditional and laparoscopic approaches for infantile hypertrophic pyloric stenosis.