Intraabdominal pyloromyotomy through the umbilical route: a technical improvement.
OBJECTIVE
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.
De Caluwe
D
D
Pediatric Surgery Unit, St-Luc University Clinics, University of Louvain Medical School, Brussels, Belgium.
Reding
R
R
de Ville de Goyet
J
J
Otte
J B
JB
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014472:Umbilicus / Q000601:surgery*