2010 Volume 46 Issue 1 Pages 28-31
Purpose: The fixation of the pyloric tumor by grasping the duodenum during conventional laparoscopic pyloromyotomy is not easy; therefore surgeons need to be adept at this surgical procedure. For better visualization and stabilization of the pyloric tumor, we applied a new technique of grasping the pylorus using a vascular clamp. The aim of this study was to assess the safety and benefits of the usage of the vascular clamp during laparoscopic pyloromyotomy. Methods: Seven infants underwent laparoscopic pyloromyotomy using the vascular clamp between April 2008 and July 2009. The operative data were collected retrospectively. Results: There were no intra- or post-operative complications in any of the 7 cases. No patients underwent conversion to open surgery. The vascular clamp could be inserted from a small stab wound incision. The mean operating time was 33.4 minutes for the laparoscopic pyloromyotomy using the vascular clamp. The use of the vascular clamp results in easier and safer manipulation of the pylorus tumor for beginners to laparoscopic pyloromyotomy. No long-term complications were reported and no redo pyloromyotomies were needed. Conclusion: Laparoscopic pyloromyotomy using the vascular clamp offered a better visualization and stabilization of the pyloric mass. It seems to be a good technique for the surgical management of hypertrophic pyloric stenosis and will become an alternative to conventional laparoscopic pyloromyotomy.
