Single-Site Umbilical Laparoscopic Pyloromyotomy Using a Pyloric Electrocoagulation Chisel Combined with a Left-Handed Main Operation for Congenital Hypertrophic Pyloric Stenosis

J Laparoendosc Adv Surg Tech A. 2020 Nov;30(11):1248-1252. doi: 10.1089/lap.2020.0478. Epub 2020 Aug 20.


Background: Laparoscopic pyloromyotomy has become a gold standard for the treatment of congenital hypertrophic pyloric stenosis (HPS). There have been recent reports on the use of transumbilical single-site laparoscopic surgery for congenital HPS; however, using transumbilical single-site laparoscopic surgery in pediatric cases is still controversial due to the difficulty with manipulation. In this study, some preliminary experience with the application of a novel transumbilical single-site laparoscopic approach in congenital HPS is described. Methods: A retrospective study was conducted involving 25 patients with congenital HPS treated in our hospital from August 2016 to August 2019. A pyloric electrocoagulation chisel combined with a left-handed main operation was completed in all of the patients and the operative times, postoperative length of stay, and operative complications were recorded. Results: The laparoscopic operation was completed in 25 patients with an average operative time of 21.9 ± 5.5 minutes, average postoperative length of stay of 2.5 ± 0.9 days, and no perforations of the pyloric mucosa, recurrent obstruction, surgical incision infections, and incision hernias. All of the patients had at least 3 months of follow-up, good growth and development, and the parents were satisfied with the postoperative scars. Conclusion: A pyloric electrocoagulation chisel combined with a left-handed main operation in the treatment of congenital HPS by a single-site umbilical laparoscopic pyloromyotomy is safe and effective, and can achieve a satisfactory cosmetic effect.

Keywords: hypertrophic pyloric stenosis; left-handed main operation; pyloric electrocoagulation chisel; pyloromyotomy; single-site umbilical laparoscopy.

MeSH terms

  • Electrocoagulation
  • Equipment Design
  • Female
  • Humans
  • Incisional Hernia / surgery*
  • Infant
  • Laparoscopy / instrumentation
  • Laparoscopy / methods*
  • Male
  • Operative Time
  • Pyloric Stenosis, Hypertrophic / surgery*
  • Pyloromyotomy / instrumentation
  • Pyloromyotomy / methods*
  • Pylorus / surgery*
  • Retrospective Studies
  • Umbilicus / surgery*