Pyloroplasty

Alternative names 
Pyloromyotomy; Pyloric stenosis repair

Definition

Pyloroplasty is surgery performed to relieve pyloric stenosis, a narrowing of the pyloric channel at the outlet of the stomach that causes projectile and nonbilious Vomiting. This surgery allows the stomach contents to empty into the duodenum (small intestine) more readily.

Description

While the patient is under general anesthesia (unconscious and pain-free), the abdomen is cleaned and draped. The surgeon makes a small incision into the abdomen and then makes a cut into the pyloric muscle (stomach outlet) down to the mucosa, which releases the restriction that has kept it closed. No tissue is removed and the stomach lining is not opened.

The pyloric muscle returns to normal size over time.

Indications
Pyloroplasty is the only effective and efficient treatment for pyloric stenosis .

Risks
Risks for any anesthesia include the following:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery include the following:

     
  • Bleeding  
  • Infection

Additional risks include puncture (perforation) of the stomach, which is rare.

Expectations after surgery
Children usually recover quickly. There are no long-term disadvantages to surgery.

Convalescence

The patient generally spends only one to two days in the hospital. Feedings by mouth are usually delayed for 12 hours after the operation. The stomach requires this short time to regain its ability to contract and to empty.

Most infants can advance from clear liquids to normal amounts of formula or breast milk within 36 hours after the operation. Vomiting of one or two feedings in the first 24 to 48 hours after the operation is not uncommon.

A small incision in your child’s right upper abdomen will be covered by paper tapes. A firm ridge may appear at the incision site, which is no cause for concern. Avoid bathing the infant for at least five days after the operation. Sponge bathing is permitted the day of discharge. Carefully pat dry the incision tapes after the sponge bath.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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