A Survey of Pediatric Surgeons’ Experience With Laparoscopic Pyloromyotomy

Charles W Hartin, M A Escobar, S T Lau, S Z Yamout, Michael G Caty, Y H Lee. Women and Children’s Hospital of Buffalo, State University of New York at Buffalo, Mary Bridge Children’s Hospital & Health Center, Kaiser Permanente Los Angeles Medical Center, University of Rochester Medical Center

 

PURPOSE: The purpose of this study is to survey practicing pediatric surgeons about their preferred technique for pyloromyotomy (laparoscopic versus open), and, if experienced, their management of mucosal perforation.

METHODS: An IRB approved survey was sent to the 889 members of the American Pediatric Surgical Association and the Canadian Association of Paediatric Surgeons. Data collected included surgeon demographics, preferred pyloromyotomy technique, experience with mucosal perforation, and repair methods.

RESULTS: 401/889 (45%) surgeons responded. Most report performing an open pyloromyotomy (55%) over a laparoscopic approach (32%). 12% use both approaches routinely. More surgeons reported having a perforation during an open pyloromyotomy (61%) than during laparoscopy (26%). Of those experiencing a mucosal perforation, 97% recognized the perforation intraoperatively during an open procedure versus 86% during laparoscopy. Most surgeons (85%) converted to an open procedure for repair when encountering a mucosal perforation during laparoscopy. Primary mucosal repairs with Graham patch was the most common repair technique reported.
 

CONCLUSIONS: Of the pediatric surgeons surveyed, more performed open pyloromyotomy. More surgeons experienced a mucosal perforation during an open procedure compared to a laparoscopic procedure. Graham patch was the repair of choice. Mucosal perforations were less likely to be recognized during laparoscopy than during open repair.
 


Session Number: Poster – Poster Presentations
Program Number: P208
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