The next generation of miniature access pyloric spreader

Surgeons are always striving to improve miniature access surgery by developing new techniques and instruments. Based on our understanding that the original Ramstedt pyloromyotomy and the Benson pyloric spreader are time-tested for open surgery, we designed a unique miniature access pyloric spreader. The instrument, modeled after the Benson spreader, was used in eight infants with pyloric stenosis. The spreader has the following unique features: It is slim, opens with double action, is serrated on both sides, is angled, and can be used without a trocar. The use of the miniature access pyloric spreader facilitated the performance of the crucial step in the pyloromyotomy procedure. Its slim size allowed the spreader to fit easily into the myotomy incision. Serrations outside the spreader created enough friction to prevent the instrument from sliding. The double action mechanism allowed the equal distribution of force on both sides of the myotomy. Percutaneous introduction without a trocar decreased abdominal trauma and improved cosmesis. The miniature access percutaneous pyloric spreader is a useful instrument for miniature access pyloromyotomy. It improves surgical precision, avoids unnecessary movements, and minimizes potential complications.