Introduction: Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting
in infancy which can be treated by pyloromyotomy after correction of pH and electrolytes imbalance. Infantile
hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting in infancy which can be treated
by pyloromyotomy after correction of pH and electrolytes imbalance.
Aim of work: To Compare between laparoscopic and open (Right upper quadrant incision) approach for
pyloromyotomy in the management of infants with infantile hypertrophic pyloric stenosis regard their operative
time, hospital stay, postoperative complications and cosmoses.
Patients and methods: A prospective study of 40 patients with IHPS was done. (20 by laparoscopy and 20
by open approach) To Compare between laparoscopic and open (Right upper quadrant incision) approach in
pyloromyotomy in infants with infantile hypertrophic pyloric stenosis regard their operative time, hospital stay,
postoperative complications and cosmoses.
Results: This study was conducted on 40 patients with infantile hypertrophic pyloric stenosis (IHPS) randomly
divided into two groups, A and B. Laparoscopic pyloromyotomy was performed on group A while Group B underwent
open pyloromyotomy through a transverse right upper quadrant incision. Throughout the study, 31 (77.5%) male
babies were diagnosed with IHPS, while only 9 (22.5%) female babies were diagnosed during the study with 3.4:1
male to female Ratio. Open pyloromyotomy needed less operative time (mean 28.6 mins ), while laparoscopic
pyloromyotomy took more time ( Mean 36.8 mins ) intraoperatively and needs more experience for the surgeon
in dealing with laparoscopic tools. According to the study, Patients underwent open pyloromyotomy needed more
hospital stay ( Mean 2.9 days ) till achievement of full feeding than laparoscopic pyloromyotomy ( mean 1.7 days ).
Through the study, we addressed cosmetic results according to patient's parent or guardian satisfaction to cosmetic
results. 4 cases' (20% of the total group) Parents in group A complained of the shape of the scar and wished if it
was better (Shown in the next picture), while parents in Group B was satisfied with the post operative scar which
was mostly unnoticed.
Conclusion: The study revealed that laparoscopic pyloromyotomy has excellent cosmesis, less hospital stay,
with operative time and complications comparable rates to open approach, so it can be considered as a standard
technique for treatment of IHPS.