Ramstedt's pyloromyotomy

Indications

Pyloric stenosis

 

 

Procedure

  1. GA
  2. 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
  3. Split pyloric muscles
    • Rotate pylorus
    • Incise visceral peritoneum over lenght of tumour
    • Using blunt forceps, longitudinal and circular muscles are split down to submucosa
  4. Finish
    • Identify any inadvertant leaks (and repair with omental patch)
    • Close abdominal wound with interrupted absorbable sutures
    • Close skin with subcuticular sutures