Ramstedt's pyloromyotomy--what is the correct incision?
Hingston, G.
New Zealand Medical Journal 109(1026): 276-278
1996
ISSN/ISBN: 0028-8446 PMID: 8769050 Document Number: 458758
Aim: To retrospectively review Starship's complication rates of the vertical midline incision and transverse right upper quadrant incision in Ramstedt's pyloromyotomy. Method: A retrospective chart and operation note review over a seven and a half year period of all infants having a Ramstedt's pyloromyotomy for infantile hypertrophic pyloric stenosis at Auckland Hospital. Results: Of 140 patients there were 117 transverse and 18 midline incisions (with 5 exclusions). No statistically significant differences were found between either group for wound dehiscence, wound infection or incisional hernia. However, wound dehiscence occurred relatively more often in the midline group (2/18) than in the transverse group (3/117), although this did not reach statistical significance (Fisher exact test p-value = 0.15). Conclusions: There is no convincing evidence that either incision is better than the other. There is a low number of wound complications occurring at Starship with Ramstedt's operation. Overall results compare favourably with both New Zealand and overseas institutions.