title: Ramstedt's pyloromyotomy--what is the correct incision?
abstract: OBJECTIVE
  To retrospectively review Starship's complication rates of the vertical midline incision and transverse right upper quadrant incision in Ramstedt's pyloromyotomy.
  
  
  METHODS
  A retrospective chart and operation note review over a seven and a half year period of all infants having a Ramstedt's pyloromyotomy for infantile hypertrophic pyloric stenosis at Auckland Hospital.
  
  
  RESULTS
  Of 140 patients there were 117 transverse and 18 midline incisions (with 5 exclusions). No statistically significant differences were found between either group for wound, dehiscence, wound infection or incisional hernia. However, wound dehiscence occurred relatively more often in the midline group (2/18) than in the transverse group (3/117), although this did not reach statistical significance (Fisher exact test p-value = 0.15).
  
  
  CONCLUSIONS
  There is no convincing evidence that either incision is better than the other. There is a low number of wound complications occurring at Starship with Ramstedt's operation. Overall results compare favourably with both New Zealand and overseas institutions.
authors.affiliation: Starship Children's Health, Auckland.
authors.forename: G
authors.initials: G
authors.lastname: Hingston
mesh_terms: D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology / Q000401:mortality; D011707:Pyloric Stenosis / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods