Pyloromyotomy: Causes, Symptoms, Treatment and Cost

Pyloromyotomy is a surgical procedure that divides the muscle of the pylorus, which is a small opening between the stomach and small intestine.

Open pyloromyotomy

A pyloromyotomy is a surgical technique that involves cutting the muscle at the bottom of the stomach to expand the passage between the stomach and the small intestine. This operation is most often used to treat hypertrophic pyloric stenosis, a disease in which the pylorus, or lower end of the stomach, thickens abnormally and lessens the flow of food from the stomach into the small intestine.

The procedure involves making an incision in the abdomen and cutting through part of the circular muscle around the opening of the pylorus. The enlarged opening enables food to enter the small intestine more freely.

Laparoscopic pyloromyotomy

Laparoscopic pyloromyotomy is a minimally invasive surgical procedure used to treat hypertrophic pyloric stenosis, a condition in which the muscle of the pylorus (the lower part of the stomach) becomes abnormally thickened, leading to obstruction of food from entering the small intestine.

During this technique, a narrow telescope with a camera on one end is introduced via tiny incisions in the belly. The surgeon then uses special instruments to cut and divide the thickened muscle fibres of the pylorus. This lowers pressure and enables food to enter the small intestine more smoothly.

Laparoscopic pyloromyotomy has been shown to be effective in treating hypertrophic pyloric stenosis with fewer complications than traditional open surgery.

Endoscopic pyloromyotomy

To cure pyloric stenosis, a minimally invasive surgical technique known as endoscopic pyloromyotomy is often used. This condition occurs when the opening of the stomach (pylorus) becomes narrowed and thickened, making it difficult for food to pass through.

During the procedure, a small incision is made in the pylorus and special instruments are used to cut and enlarge it. The enlarged opening allows food to pass through more easily. Endoscopic pyloromyotomy can be performed on both adults and children, with most patients experiencing a full recovery within two weeks after surgery.

Robotic pyloromyotomy

Robotic pyloromyotomy is a surgical procedure in which a surgeon uses a robotic device to perform a pyloromyotomy, which is the cutting of the muscles of the stomach to treat pyloric stenosis. This procedure is minimally invasive, meaning it requires only small incisions in the abdomen and can be done with less pain and shorter recovery time than traditional open surgery.

The robotic device is guided by an experienced surgeon who has extensive knowledge of anatomy and surgical techniques. During the procedure, the robot's arms are inserted through tiny incisions in the abdomen and used to cut away excess muscle tissue from around the pylorus. The surgeon then stitches up the remaining tissue, leaving a small scar that should heal within several weeks.

• The main benefit of pyloromyotomy is that it can provide relief from symptoms associated with pyloric stenosis, such as vomiting, difficulty swallowing, and abdominal pain.
• It can also help prevent dehydration due to vomiting by allowing food to pass through the digestive tract more easily.
• This procedure can reduce the risk of long-term complications such as malnutrition and poor growth due to inadequate nutrition intake.
• As it does not involve any major abdominal surgery or general anaesthesia, it tends to be less invasive than other treatments for this condition.

Pyloromyotomy is a surgical operation used to treat pyloric stenosis, a disease in which the stomach muscles thicken and constrict, preventing food from passing from the stomach to the small intestine.

This procedure is usually successful in relieving symptoms and restoring normal digestion.

The most common risks associated with pyloromyotomy are bleeding, infection, and scarring.

Less common risks include perforation of the stomach or intestines, and damage to the nerves that control the stomach muscles.

In rare cases, a pyloromyotomy can cause digestive problems such as dumping syndrome or difficulty swallowing.

• Before undergoing a pyloromyotomy, it is important to discuss the procedure with your doctor and have any questions answered.
• You should also notify your doctor of any medical ailments you may be suffering from, as well as any drugs or supplements you are taking.
• It is essential that you follow your doctor's advice for preoperative preparation.
• This may include fasting for several hours prior to the procedure, avoiding certain medications and supplements, and scheduling laboratory tests or other imaging studies.
• Additionally, your doctor might advise you to stop smoking before the treatment.
• Since general anaesthesia will be required during the treatment, make arrangements for an individual to drive you home afterward.

• The surgery is usually done under general anaesthesia, with an incision made in either the abdomen or chest area.
• The surgeon then separates the pylorus muscle from its surrounding tissue and cuts it to widen the opening.
• The cut edges are then sutured together to help keep them from closing back up.
• Afterwards, patients may need to stay in hospital for a few days for recovery and monitoring before they can go home.

• Inform the patient about the surgery and get their agreement.
• Administer preoperative medications, such as antibiotics and a proton pump inhibitor.
• Install an intravenous line so that fluids and medications may be given to the patient as needed during the surgery.
• Obtain laboratory tests, such as complete blood count (CBC), electrolytes, liver function tests, coagulation studies, and urinalysis if indicated.
• Insert a nasogastric tube to decompress the stomach before beginning the procedure.
• Monitor vital signs including pulse oximetry and ECG throughout the procedure as needed to ensure patient safety and comfort during surgery.
• Position the patient in a supine position with head elevated 30 degrees or more to facilitate exposure of pylorus area during surgery
• Prepare sterile instruments for use during the operation including scalpel, retractors, forceps, sutures etc

• Make an incision in the abdominal wall over the pylorus region using a scalpel or electrocautery device (electrocautery is preferred).
• Retract the skin edges with retractors to expose the underlying muscle layer of pyloric sphincter muscle (muscle layer beneath mucosa).
• Cut through circular muscle fibres of sphincter using scissors or electrocautery device in order to expose the mucosal layer of the pylorus region completely .
• Inspect area for any abnormalities such as ulceration or inflammation before proceeding further .
• Divide the mucosal layer along the longitudinal axis with scissors or electrocautery device while retracting tissue on either side with forceps or retractors .
• Inspect area again after dividing mucosal layer for any abnormalities such as ulceration or inflammation before proceeding further .
• Close incision by suturing skin edges together using absorbable suture material such as vicryl suture material in order to provide better cosmetic results after healing has occurred postoperatively

• Close the abdominal incision with sutures and/or staples.
• Observe the patient's vital indicators, such as temperature, heart rate, and blood pressure.
• Administer antibiotics as prescribed by the physician.
• Check any symptoms of infection, like redness or swelling at the location of the incision or fever.
• Provide pain management as prescribed by the physician, such as oral medications or injections into the abdomen to relieve pain and discomfort at the incision site.
• Instruct patient on diet restrictions after surgery, such as avoiding acidic foods and eating smaller meals more frequently to prevent vomiting and nausea associated with pyloromyotomy surgery recovery period
• Follow up with physician for post-operative care instructions including wound care and activity restrictions

The cost of a pyloromyotomy in India will vary depending on the hospital, surgeon and any additional services required.

Generally, the cost for a pyloromyotomy in India ranges from approximately Rs. 15,000 to Rs. 25,000.

After a pyloromyotomy, it is important to follow a soft diet for the first few days.

This includes foods that are easily digestible such as cooked cereals, mashed potatoes, soups, pureed fruits and vegetables, and well-cooked lean meats.

Pyloromyotomy is a safe surgical procedure that is used to treat pyloric stenosis, a condition in which the stomach's outlet is narrowed.

Generally, the operation is painless, since it is conducted under general anaesthetic.Nevertheless, owing to swelling and inflammation, patients may have pain and discomfort following surgery.

Typically, pain medicines are recommended to help control this pain.

Recovery from pyloromyotomy typically takes about 4-6 weeks.

• The most common side effects of Pyloromyotomy are abdominal pain, nausea, vomiting and bloating.
• Other less common side effects include fever, infection, constipation, diarrhoea and gas. In some cases, a temporary narrowing of the stomach opening (stricture) may occur after the surgery.
• This can cause difficulty swallowing and may require further treatment.
• In rare instances, an ulcer may occur at the incision site.

• Immediately following surgery, it's important to monitor vital signs closely and watch for any signs of infection or bleeding.
• Patients should be encouraged to drink plenty of fluids and eat soft foods such as applesauce, yoghourt, or mashed potatoes for the first few days after surgery.
• Pain medications may be prescribed by your doctor to help alleviate any discomfort caused by the incision site and swelling in the abdomen.
• It's important to avoid strenuous activities such as lifting heavy objects or running for at least two weeks after surgery in order to allow adequate time for healing and reduce any risk of complications or injury from overexertion.
• Follow-up visits with your doctor are essential after pyloromyotomy in order to monitor healing progress and ensure that no further complications arise from the procedure.

The pyloromyotomy procedure was successful in treating the patient's condition. The patient experienced significant relief of symptoms and had no postoperative complications. The procedure is a safe and effective treatment for pyloric stenosis, and can be used to provide long-term relief from symptoms.