SURFACE UMBILICAL PYLOROMYOTOMY

Background: Despite much initial enthusiasm, umbilical pyloromyotomy h as failed to achieve widespread popularity. This mostly relates to dif ficulty with delivering the pyloric tumour through the relatively smal l incision. Method: A new technique for umbilical pyloromyotomy is des cribed in which a circumumbilical skin incision with a right lateral e xtension is combined with transverse division of the linea alba and pa rt 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 experi ence of 30 cases in which this technique was successfully employed. Th e pyloromyotomy was done on the surface in all cases and the resulting scar was barely visible in the folds of the umbilicus.