Can a simplified algorithm prevent incomplete laparoscopic pyloromyotomy?

Journal of Pediatric Surgery
M Reza VahdadGrigore Cernaianu

Abstract

The purpose of this study is to analyze an algorithm intended to prevent incomplete pyloromyotomy in 3-port laparoscopic (3TP) and laparoendoscopic single-site (LESS-P) procedures in a teaching hospital. We defined the pyloroduodenal and pyloroantral junctions as anatomical margins prior pyloromyotomy by palpating and coagulating the serosa with the hook cautery instrument. Incomplete pyloromyotomies, mucosa perforations, serosa lacerations, and wound infections were recorded for pediatric surgical trainees (PST) and board-certified pediatric surgeons (BC). We reviewed the medical files of 233 infants, who underwent LESS-P (n=21), 3TP (n=71), and open pyloromyotomy (OP, n=141). No incomplete pyloromyotomies occurred. In contrast to OP, mucosa perforations did not occur in the laparoscopic procedures during the study period (6.38% vs. 0%, P=.013). OP had insignificantly more serosal lacerations (3.5% vs. 1.4%, P=.407). There was no difference in the rate of wound infections between OP and laparoscopic procedures (2.8% vs. 4.3%, P=.715). In the latter, all wound infections were associated with the use of skin adhesive. This algorithm helps avoiding incomplete laparoscopic pyloromyotomy during the learning curve and in a teaching ...Continue Reading

References

Jul 29, 2009·Journal of Pediatric Surgery·Juan E Sola, Holly L Neville
Apr 14, 2011·Surgical Endoscopy·Oliver J MuenstererCarroll M Harmon
Dec 20, 2011·Pediatric Surgery International·Yury KozlovPavel Yurkov
Jan 17, 2012·Journal of Pediatric Surgery·Sabina SiddiquiAlfred P Kennedy
Apr 7, 2012·The Journal of Surgical Research·Emma V CarringtonSimon Eaton
Apr 16, 2013·Surgical Endoscopy·Matthijs OomenHugo Heij
Jun 24, 2014·Journal of Pediatric Surgery·Nigel J HallAgostino Pierro

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Citations

Dec 22, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Lucy HendersonHaitham Dagash

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