Ramstedt's pyloromyotomy
Indications
Pyloric stenosis
Procedure
- GA
- Access pylorus
- 3-4cm transverse incision made in right upper quadrant over palpable pyloric tumour
- advanced through rectus sheath, sheath, into peritoneum
- Deliver greater curvature of stomach into woun
- Split pyloric muscles
- Rotate pylorus
- Incise visceral peritoneum over lenght of tumour
- Using blunt forceps, longitudinal and circular muscles are split down to submucosa
- Finish
- Identify any inadvertant leaks (and repair with omental patch)
- Close abdominal wound with interrupted absorbable sutures
- Close skin with subcuticular sutures
