Laparoscopic pyloromyotomy is both safe and effective in a district hospital

Introduction: Functional operations of the gastrointestinal tract are ideal indications for minimal-access surgery. The aim of this paper was to assess the safety and potential benefits of the laparoscopic Ramstedt pyloromyotomy using the experience of a single surgeon in a district general hospital. Methods: 90 consecutive infants underwent pyloromyotomy: 35 open procedures and 55 laparoscopic procedures. This is a retrospective study but the operative data of the laparoscopic group were collected prospectively. Results: There were no differences in demographic data between the groups. The open group had a shorter mean operating time, 22.14 min, than the laparoscopic group, 26.04 min (p = 0.022). There was no significant difference in the time to full feed between the two groups (p = 0.076). 62.9% of the infants in the open group vomited compared with only 43.4% in the laparoscopic group (p = 0.058). The laparoscopic group had shorter postoperative stay, 62.33 hours, compared to 91.89 hours (p = 0.001). There was one reoperation in each group: for complete wound dehiscence in the open group and for incomplete myotomy in the laparoscopic group. Conclusions: Laparoscopic pyloromyotomy (LPM) is as safe as the open procedure and has the potential benefits of shorter hospital stay and improved cosmesis.