In this BoardsCast episode, we continue Tobias Chapter 91 by exposing one of the most deceiving failure patterns in soft-tissue surgery:

👉 The pylorus is not a pipe you “open.”
 It is a timing valve in a pressure-driven pump.

Surgeons often judge pyloric surgery by one metric —
 “Is the lumen open?”
But gastric outflow doesn’t fail because the hole is too small.
It fails because the timing mechanism of the antrum–pylorus unit has been disrupted.

This episode reframes pyloric surgery from structural plumbing to physiologic engineering, revealing why patients with perfect closures and wide lumens still starve, reflux, or deteriorate quietly over weeks.

You’ll learn:

• Why the stomach empties by retropulsion, not gravity — and why slamming into a closed pylorus is essential
• Why particles must be 0.1–0.63 mm before the pylorus will ever open
• How surgeons accidentally destroy the stomach’s timing, not its anatomy
• The five ways pyloric surgery causes slow, silent physiological failure
• Why edema and overhandling create functional obstruction even when the lumen looks wide
• Why PDS is the wrong suture inside the pylorus (and how it creates strictures)
• The difference between muscular vs mucosal disease — and why biopsy is mandatory
• When to use Fredet-Ramstedt, Heineke–Mikulicz, or Y-U advancement — and when each one will fail
• Why most dogs with “open pylorus but persistent vomiting” actually have functional gastric failure

If you think pyloric surgery is about widening a hole, this episode will fundamentally change your mental model — and your outcomes.

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