A new technique for performing endoscopic pyloromyotomy by gastric submucosal tunnel dissection.

Aim: To investigate the feasibility of a new endoscopic pyloromyotomy technique.
Materials and Methods: Endoscopic pyloromyotomy through a gastric submucosal tunnel was performed in 6 pigs. At the greater curvature, 2 cm proximal to the pylorus, we incised the mucosa and dissected the submucosal tunnel up to the pyloric ring. The pyloric muscular ring was sectioned, and then the gastric mucosal incision was closed with metallic clips. The pigs were then euthanized and necropsies were performed.
Results: Section of the pyloric ring was successful in all 6 pigs. Small perforations occurred in 2 of the pigs, and there was limited bleeding in 1 pig. Necropsy and histologic evaluation confirmed the pyloric section.
Conclusions: This technique is feasible, easy to perform, and maybe alternative to pyloroplasty in selected cases. Experimental comparative studies with other techniques still must be performed.