ABSTRACT
The operative approach to the pyloromyotomy has also undergone a number of modifications in the last few decades. Up until the 1990s, the majority of surgeons approached the pylorus through either a transverse or midline incision in the upper abdomen. Frequently, the cosmetic result was unsatisfactory. In 1986, Tan and Bianchi reported the use of a paraumbilical incision to approach the pylorus with superior cosmesis and this has become the standard open approach in many centers. More recently, laparoscopic pyloromyotomy has been reported and has superseded an open procedure in many specialist pediatric surgical units.
