Circumumbilical pyloromyotomy in the era of minimally invasive surgery

Preliminary experience with a new approach for infantile hypertrophic pyloric stenosis: the single-port, laparoscopic-assisted pyloromyotomy

“…In 1986, Tan and Bianchi [6] described a new technique in which the pyloromyotomy was performed through a supra umbilical skin-fold incision, and in 1991, Alain et al [7] introduced the laparoscopic approach. During the past few years, many surgeons have preferred to perform laparoscopic pyloromyotomy (LP) but as many continue to perform open surgery by circumbilical incision or by other ways [3,[8][9][10]. The approach to the pylorus to perform pyloromyotomy is still debated and many authors in recent years have compared the various approaches looking for the best, considering the complications, [17] reported an absence of complications in a large series of LP, other authors have demonstrated that this technique may expose patients to a higher risk of inadequate pyloromyotomy and duodenal perforation because of a longer learning curve [11,13,18].…”

“…Our high level of confidence and experience with laparoscopic-assisted procedures performed in neonatal surgery led us to prefer a laparoscopicassisted approach instead of the laparoscopic one. In our 19 cases, we performed the SPLAP with a right semicircular incision, which provides an almost invisible unique scar and a cosmetic outcome with a very high overall satisfaction [8].…”

Supraumbilical Pyloromyotomy: A Comparative Study Between Intracavitary and Extracavitary Techniques

“…The first pyloromyotomy described by Ramstedt in 1912 via a vertical midline incision, modified later to the right upper quadrant (RUQ) approach by Randolph. [1][2][3] Although effective as providing excellent exposure of the pylorus with almost minimal complications this procedure results in a permanent abdominal scar that grows with the child and became significant with time to the extent that these children regard it as a stigma. 4,5 Different approaches have been advocated for pyloromyotomy including the umbilical skin fold incision (UMB) either supra umbilical incision popularized by Tan and Bianchi in 1986 6 or the right semicircular umbilical skin fold incision introduced by Alberti et al in 2004.…”

Single-port laparoscopic-assisted pyloromyotomy

“…In our 38 cases treated, we performed the SPLAP with a right semicircular incision, which provides an almost invisible unique scar and a cosmetic outcome with a very high overall satisfaction [30] (Fig. 3).…”