Ramstedt's procedure is used in the treatment of infantile pyloric stenosis.
Procedure:
- child is placed under general anaesthesia
- the operation is preceded by gastric lavage and carried out under continuous nasogastric aspiration
- a longitudinal incision is made through the hypertrophied muscle as far as the mucosa; the mucosa is left intact and is seen bulging into the incision
- the cut edges are separated
Post-operative feeding begins after 3 hours, initially with glucose-water followed by 3 hourly milk feeds.
Complications:
- gastro-enteritis: this is common is the debilitated child and may indicate a breakdown in aseptic feeding techniques
- peritonitis from perforation through the mucosa
- bleeding from the incision
- residual stenosis: may require repeated surgery and division of remaining muscle fibres
- wound infection and postoperative pyrexia
- burst abdomen
Results are good and mortality is very low.