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Pyloromyotomy is surgery used to treat infantile hypertrophic pyloric stenosis, a condition in which the pyloric muscle becomes abnormally thick and blocks stomach emptying. The surgeon splits the thickened outer muscle fibers of the pylorus without opening the inner stomach lining. This releases the constriction and allows stomach contents to pass more normally into the duodenum. No portion of the pylorus needs to be removed.
read more about pyloromyotomy ...The procedure is performed for infants with confirmed hypertrophic pyloric stenosis causing progressive nonbilious vomiting and gastric outlet obstruction. Before surgery, dehydration and electrolyte abnormalities caused by repeated vomiting must be corrected with intravenous fluids. Ultrasound is commonly used to confirm thickening and elongation of the pylorus. Once the infant is adequately hydrated and metabolically stable, pyloromyotomy provides definitive treatment for the obstruction.
The procedure can be performed through a small open incision or laparoscopically through several small ports. The surgeon exposes the pylorus and makes a longitudinal cut through the thickened muscle down to the level of the intact mucosa. The divided muscle edges are spread apart so the gastric outlet can open more freely. The surgeon checks carefully for mucosal perforation and for an incomplete muscle split before finishing the operation.
Feedings are restarted gradually after surgery, often within several hours once the infant is awake and clinically stable. Mild vomiting can continue for a short time because the stomach and pylorus need time to resume coordinated emptying. Intravenous fluids are continued until oral intake is sufficient and hydration is stable. Most infants recover quickly and are discharged once they are feeding adequately and there are no significant complications.
Possible complications include wound infection, bleeding, mucosal perforation, incomplete pyloromyotomy, and persistent vomiting. A perforation of the inner lining generally requires immediate repair during surgery. An incomplete muscle division can leave the outlet too narrow and can require repeat intervention. Major complications are uncommon, and both open and laparoscopic pyloromyotomy are established treatments with high success rates.
No. The surgeon divides the thickened pyloric muscle but does not remove the stomach or pylorus.
Repeated vomiting can cause dehydration and abnormal electrolyte levels. These problems are corrected before anesthesia because pyloric stenosis is treated urgently but not before the infant is stabilized.
Yes. Mild vomiting can continue for several days as the stomach recovers, but persistent forceful vomiting can require further evaluation.
Yes. Laparoscopic and open pyloromyotomy are both accepted surgical approaches for infantile hypertrophic pyloric stenosis.
Pyloric Stenosis. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/pyloric-stenosis. Date Accessed September 11, 2026.
Pyloric Stenosis (HPS): Symptoms & Causes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4524-pyloric-stenosis-hps. Date Accessed September 11, 2026.
Pyloric Stenosis. Children's Hospital of Philadelphia. https://www.chop.edu/conditions-diseases/pyloric-stenosis. Date Accessed September 11, 2026.
Pyloric Stenosis in Infants. MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000970.htm. Date Accessed September 11, 2026.
Pyloric Stenosis. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK555931/. Date Accessed September 11, 2026.