Trocarless laparoscopic pyloromyotomy with conventional instruments: Our experience

Abstract

Background: The incidence of hypertrophic pyloric stenosis is approximately 1-3 per 1,000 live births. Hypertrophic pyloric stenosis is seen more often in males, with a male-to female ratio of 4:1. Laparoscopic pyloromyotomy is becoming increasingly popular as the standard treatment for hypertrophic pyloric stenosis.

Materials and methods: We describe our initial experience with laparoscopic pyloromyotomy in 16 infants using conventional laparoscopic instruments. Laparoscopic pyloromyotomy was performed through 5-mm umbilical port with 5mm 30 endoscope. Two 3-mm working instruments were inserted directly into the abdomen via separate lateral incisions.

Results: All patients were prospectively evaluated. The procedure was performed in 16 infants with a mean age of 36 days and mean weight of 3.1 kg. All procedures, except two, were completed laparoscopically with standard instruments. Average operating time was 28 mins, and average postoperative length of stay was 2.8 days. There were no major intraoperative and postoperative complications.

Conclusion: Laparoscopic pyloromyotomy can be safely performed by using standard conventional laparoscopic trocarless instruments.

Keywords: Conventional instruments; laparoscopic; pyloromyotomy; trocarless.

Figure 1

Initial incision

Figure 2

Complete pyloromyotomy

Figure 3

Post-operative