title: Transumbilical pyloromyotomy with umbilicoplasty provides ease of access and excellent cosmetic results.
abstract: OBJECTIVE
  Cosmesis is considered one of the key reasons to perform pyloromyotomies through the umbilicus. We describe the results of pyloromyotomy using a supraumbilical incision with umbilicoplasty that allows ease of mobilization of the pylorus and excellent cosmetic results.
  
  
  METHODS
  The charts of all patients undergoing transumbilical pyloromyotomy with umbilicoplasty from 2002 to 2006 were retrospectively reviewed. Demographic data as well as operative time, details of surgical technique, and outcome were collected and analyzed.
  
  
  RESULTS
  Thirty-eight patients underwent a transumbilical pyloromyotomy with umbilicoplasty. The average operative time was 39.2 minutes (range, 11-66 minutes). The time to tolerating feeds was 1.14 days (range, 1-3 days), and the average length of stay was 1.84 days (range, 1-8 days). There were 2 complications: periumbilical cellulitis (n = 1) and incisional hernia (n = 1). There were no perforations and no incomplete pyloromyotomies. The cosmetic results on postoperative follow-up were subjectively excellent.
  
  
  CONCLUSIONS
  Transumbilical pyloromyotomy with umbilicoplasty combines ease of exposure with ease of mobilization of the pylorus. There is minimal morbidity and an excellent cosmetic result. Time to average feeding, length of stay, and complications are similar to published reports of both open and laparoscopic pyloromyotomy.
authors.affiliation: Division of Pediatric Surgery, The Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: David
authors.initials: D
authors.lastname: Lazar
authors.forename: Bindi
authors.initials: B
authors.lastname: Naik
authors.forename: Megan E
authors.initials: ME
authors.lastname: Fitch
authors.forename: Jed G
authors.initials: JG
authors.lastname: Nuchtern
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
mesh_terms: D006801:Humans; D046248:Pyloric Stenosis, Hypertrophic / Q000601:surgery*; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies; D014472:Umbilicus / Q000601:surgery*