[Results of periumbilical approach to hypertrophic pyloric stenosis treatment. Personal experience]

Ramstedt's pyloromyotomy is the universally accepted treatment for hypertrophic pyloric stenosis. It could be performed through different surgical approaches: Robertson muscle splitting incision, transverse right transrectal incision, median longitudinal incision laparoscopic approach and circumumbilical incision.

This latter technique was successfully personally utilized for the treatment of 33 consecutive patients; 29 patient were male and 4 female, age ranged from 15 to 52 days (median value 32.6 days), previously full term, normal weighing newborns. In all patients but one, the large pyloric mass bulged through the incision and the Ramstedt's pyloromyotomy was performed as usual. In one case, the pyloromyotomy has been done through the incision by holding the large pylorus firmly beneath the abdominal wall. The operative time has been quite similar to that obtained with the transverse right incision. The mean hospitalization period has been of four days.

No operative or postoperative complications were observed. Particularly, despite no antibiotics were used, no wounds infections occurred.

The esthetic result was satisfying in all cases after one month follow-up.