Methylene blue: a simple marker for intraoperative detection of gastroduodenal perforations during laparoscopic pyloromyotomy.
BACKGROUND
We studied the feasibility of using methylene blue (MB) as a marker to detect mucosal perforations during laparoscopic pyloromyotomy using in vitro and in vivo animal models.


METHODS
MB was initially tested in pig stomachs in vitro. Information gathered from these experiments was then used to test the marker during experimental live piglet laparoscopic surgery.


RESULTS
MB stained the gastric mucosa blue; this tint could be seen through the intact mucosal layer exposed via myotomy. Dye extravasation was seen during laparoscopic surgery with mucosal perforations of 1.2 mm and greater with or without air insufflation of the stomach. Air extravasation was seen with perforations of 2.0 mm and greater.


CONCLUSIONS
Full strength 1% MB dye instilled into the gastric lumen can potentially be used as a marker for detection of mucosal perforations of 1.2 mm or greater during laparoscopic pyloromyotomy.
Vegunta
Ravindra K
RK
University of Illinois College of Medicine at Peoria and Children's Hospital of Illinois at OSF St Francis Medical Center, Peoria, IL, USA. vegunta@uic.edu
Rawlings
Arthur L
AL
Jeziorczak
Paul M
PM
D000818:Animals; D004396:Coloring Agents; D004195:Disease Models, Animal; D004386:Duodenum / Q000293:injuries*; D005240:Feasibility Studies; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects; D008751:Methylene Blue; D046248:Pyloric Stenosis, Hypertrophic / Q000150:complications / Q000601:surgery*; D011708:Pylorus / Q000601:surgery; D013270:Stomach / Q000293:injuries*; D013552:Swine
D004396:Coloring Agents; D008751:Methylene Blue