Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

The Evolution of an Ideal Surgical Incision for Pyloric Stenosis

The Evolution of an Ideal Surgical Incision for Pyloric Stenosis Abstract EARLY in the surgical history of congenital pyloric stenosis, the operative approach was involved and often complicated. The infants who were brought to surgery were seriously depleted and many weeks past the age that the diagnosis is made today. Formal laparotomy was the standard procedure through a generous paramedian incision (Fig 1, A).1 Because of the debility of the tiny patient and the less sophisticated replacement therapy, wound dehiscence, evisceration, and death occurred all too frequently. To this distressing clinical problem, Robertson2 brought a fresh look when he conceived the right-upper-quadrant, musclesplitting incision. This surgical incision was a counterpart in the upper abdomen of the McBurney incision in the right lower quadrant (Fig 1, B). Recognizing wound healing as a major cause of death in these desperately ill infants, Robertson demonstrated that if the lateral abdominal musculature were split in fiber direction, the external and internal oblique muscles References 1. Donovan, E.J.: Congenital Hypertrophic Pyloric Stenosis in Infancy , Ann Surg 95:174-182 ( (Feb) ) 1932.Crossref 2. Robertson, D.E.: Congenital Pyloric Stenosis , Ann Surg 112:687-699 ( (Oct) ) 1940.Crossref 3. Schuster, S.R., and Colodny, A.H.: A Useful Maneuver to Simplify Pyloromyotomy for Hypertrophic Pyloric Stenosis , Surgery 55:735-736 ( (May) ) 1964. 4. Bill, A.H.; Hoffman, H.C.; and Skinner, A.L.: The Use of a Transverse Incision Over the Liver and of Preoperative Potassium in the Care of Hypertrophic Pyloric Stenosis , Amer J Surg 106:511-516 ( (Sept) ) 1963.Crossref 5. Gross, R.E.: The Surgery of Infancy and Childhood , Philadelphia: W. B. Saunders Co., 1953. 6. Rees, J.L., and Coller, F.A.: Anatomic and Clinical Study of the Transverse Abdominal Incision , Arch Surg 47:136-146 ( (July) ) 1943.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Evolution of an Ideal Surgical Incision for Pyloric Stenosis

Archives of Surgery , Volume 93 (3) – Sep 1, 1966

Loading next page...
 
/lp/american-medical-association/the-evolution-of-an-ideal-surgical-incision-for-pyloric-stenosis-IE6OjL3GvO

References (7)

Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01330030119024
Publisher site
See Article on Publisher Site

Abstract

Abstract EARLY in the surgical history of congenital pyloric stenosis, the operative approach was involved and often complicated. The infants who were brought to surgery were seriously depleted and many weeks past the age that the diagnosis is made today. Formal laparotomy was the standard procedure through a generous paramedian incision (Fig 1, A).1 Because of the debility of the tiny patient and the less sophisticated replacement therapy, wound dehiscence, evisceration, and death occurred all too frequently. To this distressing clinical problem, Robertson2 brought a fresh look when he conceived the right-upper-quadrant, musclesplitting incision. This surgical incision was a counterpart in the upper abdomen of the McBurney incision in the right lower quadrant (Fig 1, B). Recognizing wound healing as a major cause of death in these desperately ill infants, Robertson demonstrated that if the lateral abdominal musculature were split in fiber direction, the external and internal oblique muscles References 1. Donovan, E.J.: Congenital Hypertrophic Pyloric Stenosis in Infancy , Ann Surg 95:174-182 ( (Feb) ) 1932.Crossref 2. Robertson, D.E.: Congenital Pyloric Stenosis , Ann Surg 112:687-699 ( (Oct) ) 1940.Crossref 3. Schuster, S.R., and Colodny, A.H.: A Useful Maneuver to Simplify Pyloromyotomy for Hypertrophic Pyloric Stenosis , Surgery 55:735-736 ( (May) ) 1964. 4. Bill, A.H.; Hoffman, H.C.; and Skinner, A.L.: The Use of a Transverse Incision Over the Liver and of Preoperative Potassium in the Care of Hypertrophic Pyloric Stenosis , Amer J Surg 106:511-516 ( (Sept) ) 1963.Crossref 5. Gross, R.E.: The Surgery of Infancy and Childhood , Philadelphia: W. B. Saunders Co., 1953. 6. Rees, J.L., and Coller, F.A.: Anatomic and Clinical Study of the Transverse Abdominal Incision , Arch Surg 47:136-146 ( (July) ) 1943.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1966

There are no references for this article.