Department of Pediatric Surgery, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.
Afr J Paediatr Surg. 2021 Jan-Mar;18(1):14-17. doi: 10.4103/ajps.AJPS_119_20.
Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis has become quite popular over the past decade. There have been many modifications in the technique initially described by Alain et al. in 1991. We describe our experience of the laparoscopic procedure performed in twenty cases.
This study includes twenty patients of pyloric stenosis who underwent laparoscopic pyloromyotomy from March 2017 to March 2020. All the infants had classical clinical symptoms and abdominal ultrasound confirming the diagnosis of pyloric stenosis. Two 3-mm ports and one 5-mm port were used. The duodenum was grasped to stabilise the olive; a stab knife cut to 10 mm and mounted on a needle holder was introduced through the 3-mm trocar in the left hypochondrium to perform the myotomy, and subsequently, the myotomy was spread with a 5-mm Maryland forceps. Feeding was started 6 h postoperatively.
Twenty patients with congenital idiopathic pyloric stenosis underwent laparoscopic pyloromyotomy by this technique. The average operating time was 42 min. There were no peri- or post-operative complications. The post-operative hospital stay ranged between 36 h and 54 h.
Laparoscopic pyloromyotomy using a stab knife mounted on a needle holder is a technically feasible, safe and effective surgical procedure for pyloric stenosis.
在过去的十年中，腹腔镜幽门肌切开术已成为治疗肥厚性幽门狭窄的热门选择。自 1991 年 Alain 等人最初描述该技术以来，已经有许多改进。我们描述了我们在 20 例病例中进行腹腔镜手术的经验。
本研究包括 20 例接受腹腔镜幽门肌切开术的幽门狭窄患者，这些患者于 2017 年 3 月至 2020 年 3 月接受了手术。所有婴儿均具有典型的临床症状和腹部超声证实的幽门狭窄诊断。使用两个 3mm 端口和一个 5mm 端口。用十二指肠抓住橄榄以稳定它；将 10mm 的stab 刀装入持针器，通过左季肋部的 3mm 套管针引入，进行肌切开术，然后用 5mm Maryland 止血钳扩展肌切开术。术后 6 小时开始进食。
20 例先天性特发性幽门狭窄患者采用该技术行腹腔镜幽门肌切开术。平均手术时间为 42 分钟。无围手术期或术后并发症。术后住院时间为 36 至 54 小时。
用持针器安装 stab 刀的腹腔镜幽门肌切开术是一种技术可行、安全有效的治疗幽门狭窄的手术方法。
