title: Smaller scars--what is the big deal: a survey of the perceived value of laparoscopic pyloromyotomy.
abstract: OBJECTIVE
  Laparoscopic and open pyloromyotomies are equally safe and effective, with the principal benefit of laparoscopy being better cosmesis. The goal of this study was to measure the perceived value of laparoscopic pyloromyotomy.
  
  
  METHODS
  Four hundred sixteen subjects (177 college freshmen, 126 first-year medical students, and 101 parents) were asked to complete a questionnaire after photographs of mature pyloromyotomy (open and laparoscopic) scars were shown to them. To measure the perceived value, subjects' willingness to pay hypothetical additional out-of-pocket expenses for their preferred operation was assessed. Data were analyzed using Cochran-Mantel-Haenszel test, t test and multivariable regression.
  
  
  RESULTS
  Four hundred four surveys were complete. Overall, 74% preferred the appearance after laparoscopy. Eighty-eight percent would pay an additional out-of-pocket amount for their daughter and 85% for their son to have the cosmetic outcome after laparoscopy. Respondents were willing to pay more for their daughters (P < .0001) and sons (P < .0001) than themselves. As expected, income level (P < .0001) influenced the willingness to pay, whereas ethnicity, education, number of children, and sex did not.
  
  
  CONCLUSIONS
  The cosmetic benefit of laparoscopic pyloromyotomy was valued by a wide demographic with 85% being willing to pay additional expenses for their children to have smaller scars.
authors.affiliation: Division of Pediatric Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
authors.forename: Ramanath N
authors.initials: RN
authors.lastname: Haricharan
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Aprahamian
authors.forename: Traci L
authors.initials: TL
authors.lastname: Morgan
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
authors.forename: Keith E
authors.initials: KE
authors.lastname: Georgeson
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Barnhart
mesh_terms: D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011707:Pyloric Stenosis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology