A new technique for laparoscopic repair of hypertrophic pyloric stenosis

Since 1987, pyloric traumamyoplasty, a technique for the resolution of hypertrophic pyloric stenosis, has been used in 111 patients. Continuous prensile force is applied with Babcock intestinal clamps, with consequent rupture of the muscular layer, without disruption of the mucosa. Because this is a simple procedure that requires introduction of only one noncutting instrument, it has now been applied laparoscopically in 17 patients. Twelve were under 30 days of age; seven weighed less than 3.5 kg. The hospital stay averaged 1.8 days, and the average surgical time was less than 30 minutes. Only two trocar incisions were made in each case--one for the laparoscope video camera and lamp, the other for a modified Babcock clamp. There were no deaths and no complications related to the pyloric repair procedure. The authors conclude that laparoscopic pyloric traumamyoplasty is an attractive alternative for the management of hypertrophic pyloric stenosis.