Intraabdominal pyloromyotomy through the umbilical route: a technical improvement
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D De Caluwe1, R Reding, J de Ville de Goyet
1Pediatric Surgery Unit, St-Luc University Clinics, University of Louvain Medical School, Brussels, Belgium.
Background/Purpose:
Performing a pyloromyotomy through a supraumbilical skin fold incision will leave an almost invisible scar and therefore has definitive cosmetic advantages. This alternative approach may be related to technical difficulties in delivering a large pyloric tumor when compared with the conventional pyloromyotomy through a right upper quadrant incision. However, in situ (intraabdominal) myotomy can help overcome this inconvenience.
Methods:
Of 122 cases of infantile hypertrophic pyloric stenosis operated on between January 1990 and August 1996, 29 underwent a pyloromyotomy performed intraabdominally through the umbilical route. The medical records of these babies were reviewed.
Results:
Twenty-three boys and six girls (median age, 30 days; range, 17 to 70 days) underwent surgery. The median hospital stay was 2.5 days. There were two intraoperative technical complications (small mucosal perforation) and one postoperative wound complication (abcess formation) requiring local drainage.
Conclusions:
In situ pyloromyotomy through the umbilical route is an elegant alternative in cases of a large pyloric tumor.
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