Surface umbilical pyloromyotomy

Abstract

Background: Despite much initial enthusiasm, umbilical pyloromyotomy has failed to achieve widespread popularity. This mostly relates to difficulty with delivering the pyloric tumour through the relatively small incision.

Method: A new technique for umbilical pyloromyotomy is described in which a circumumbilical skin incision with a right lateral extension is combined with transverse division of the linea alba and part of the right rectus muscle. The pyloric tumour is easily delivered to the skin surface through this generous minilaparotomy. After muscle closure the lateral skin extension is swung medially as described and incorporated within the umbilical scar.

Results: We report our experience of 30 cases in which this technique was successfully employed. The pyloromyotomy was done on the surface in all cases and the resulting scar was barely visible in the folds of the umbilicus.