What surgical interventions are used in the treatment of omphalocele and gastroschisis?

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Omphalocele :-

Ø Surgery for primary repair is most often done for a small omphalocele.

· Right after birth, the sac with the organs outside the belly is covered with a sterile dressing to protect it.

· When the doctors determine your newborn is strong enough for surgery, your baby is prepared for the operation.

· Your baby receives general anesthesia. This is medicine that allows your baby to sleep and be pain-free during the operation.

· The surgeon makes a cut (incision) to remove the sac around the organs.

· The organs are examined closely for signs of damage or other birth defects. Unhealthy parts are removed. The healthy edges are stitched together.

· The organs are placed back into the belly.

· The opening in the wall of the belly is repaired.

Ø Staged repair is done when your baby isn't stable enough for primary repair. Or, it is done if the omphalocele is very large and the organs can't fit into the baby's belly. The repair is performed the following way:

· Right after birth, a plastic pouch (called a silo) or a mesh-type of material is used to contain the omphalocele. The pouch or mesh is then attached to the baby's belly.

· Every 2 to 3 days, the doctor gently tightens the pouch or mesh to push the intestine into the belly.

· It may take up to 2 weeks or more for all of the organs to be back inside the belly. The pouch or mesh is then removed. The opening in the belly is repaired.

Gastroschisis :-

PRIMARY CLOSURE

Ø Reduced complications - Sepsis,sac dehiscence,prolonged ileus

Ø Increased complication - Hypotension,bowel ischemia, anuria, respiratory failure

STAGED CLOSURE

Ø Avoid abdominal viscera compression

Ø Allow early extubation

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