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Pyloroplasty

  • Digestive system

Definition

Pyloroplasty is a surgical procedure performed to widen the pylorus, the opening between the stomach and the small intestine.

Who is a candidate for the procedure?

This procedure is performed on a person with symptoms due to narrowing of the pyloric canal.
The canal most commonly narrows from one of two conditions:
  • pyloric stenosis, a condition that affects infants for unknown reasons. In this condition, the pylorus muscle gets too thick. This blocks food from leaving the stomach. Infants with this condition usually have severe vomiting in the first few months of life.
  • peptic ulcers. In this condition, the ulcers cause swelling and scarring of the stomach and the first part of the small intestine. This in turn may cause blockage in the pyloric canal.

How is the procedure performed?

A pyloroplasty is done under general anesthesia. This means that the person is put to sleep with medication, feels no pain and has no awareness of the surgery.
A small cut is made in the upper right side of the abdomen, through some of the muscle layers and down to the pylorus. The surgeon then makes a cut through the pylorus muscle. The muscle is then sewn back together in such a way as to widen the opening of the canal.
The abdominal muscles are then sewn and put back in place. The skin incision is closed with stitches, clips, or staples. Occasionally this procedure is performed laparoscopically, using a camera tube instrument through much smaller incisions in the belly wall.
When pyloroplasty is done because of an ulcer, other procedures may also be done at the same time. One common example is a vagotomy. This procedure involves cutting the nerve that causes the stomach to make stomach acid. This is done to reduce the output of stomach acid and the risk of future ulcers.

Sources

Harrison's Principles of Internal Medicine, Fauci et al, 1998

Complete Guide to Symptoms, Illness&Surgery, H. Griffith, M.D, 2000

Current Pediatric Diagnosis and Treatment, Hathaway, Hay, Groothuis, Paisley, 1993

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