Abdominal wall defect repair
Abdominal wall defect repair is a surgery performed to correct one of two birth defects of the abdominal wall: gastroschisis or omphalocele. Depending on the defect treated, the procedure is also known as omphalo-cele repair/closure or gastroschisis repair/closure.for Abdominal wall defect repair in Bangalore.
In some cases, for some unknown reason, while in utero, the abdominal wall muscles do not form cor-rectly. And, when the abdominal wall is incompletely formed at birth, the internal organs of the infant can either protrude into the umbilical cord (omphalocele) or to the side of the navel (gastroschisis). The size of an omphalocele varies: some are very small, about the size of a ping pong ball, while others may be as big as a grapefruit. Omphalocele repair is performed to repair the omphalocele defect in which all or part of the bowel and other internal organs lie on the outside of the abdomen in a hernia (sac). Gastroschisis repair is performed to repair the other abdominal wall defect through which the bowel protrudes with no protective sac present. Gastroschisis is a life-threatening condi-tion that requires immediate medical intervention. Surgery for abdominal wall defects aims to return the abdominal organs back to the abdominal cavity, and to repair the defect if possible. It can also be performed to create a pouch to protect the intestines until they are inserted back into the abdomen.
Abdominal wall defects occurs in the United States at a rate of one case per 2,000 births, which means that some 2,360 cases are diagnosed per year. Mothers below the age of 20 are four times as likely as mothers in their late twenties to give birth to affected babies.
Abdominal wall defect surgery is performed soon after birth. The protruding organs are covered with dressings, and a tube is inserted into the stomach to prevent the baby from choking or from breathing in the contents of the stomach into the lungs. The surgery is performed under general anesthesia. First, the pediatric surgeon enlarges the hole in the abdominal wall in order to examine the bowel for damage or other birth defects. Damaged portions of the bowel are removed and the healthy bowel is reconnected with stitches. The exposed organs are replaced within the abdominal cavity, and the opening is closed. Some-times closure of the opening is not possible, for exam-ple when the abdominal cavity is too small or when the organs are too large or swollen to close the skin. In such cases, the surgeon will place a plastic covering pouch, commonly called a silo because of its shape, over the abdominal organs on the outside of the infant to protect the organs. Gradually, the organs are squeezed through the pouch into the opening and returned to the body. This procedure can take up a week, and final closure may be performed a few weeks later. More surgery may be required to repair the abdominal muscles at a later time for Abdominal wall defect repair in Bangalore..
Prenatal screening can detect approximately 85% of abdominal wall defects. Gastroschisis and ompha-locele are usually diagnosed by ultrasound examina-tions before birth. These tests can determine the size of the abdominal wall defect and identify the affected organs. The surgery is performed immediately after delivery, as soon as the newborn is stabl
After surgery, the infant is transferred to an intensive care unit (ICU) and placed in an incubator to keep warm and to prevent infection. Oxygen is provided. When organs are placed back into the abdominal cavity, this may increase pressure on the abdomen and make breathing difficult. In such cases, the infant is provided with a breathing tube and ven-tilator until the swelling of the abdominal organs has decreased. Intravenous fluids, antibiotics, and pain medication are also administered. A tube is also placed in the stomach to empty gastric secretions. Feedings are started very slowly, using a nasal tube as soon as bowel function starts. Babies born with omphaloceles can stay in the hospital from one week to one month after surgery, depending on the size of the defect. Babies are discharged from the hospital when they are taking all their feedings by mouth and gaining weight.
QUESTIONS TO ASK THE DOCTOR
- What will happen when my baby is born?
- Does my baby have any other birth defects? What are my baby’s chances of full recovery? Will my baby have a ‘‘belly button’’?
- How many abdominal wall defect surgeries do you perform each year?
- How many infants have you operated on during your practice?
The risks of abdominal wall repair surgery include peritonitis and temporary paralysis of the small bowel. If a large segment of the small intestine is damaged, the baby may develop short bowel syndrome and have digestive problems.for Abdominal wall defect repair in Bangalore.
In most cases, the defect can be corrected with surgery. The outcome depends on the amount of dam-age to the bowel for Abdominal wall defect repair in Bangalore.
Morbidity and mortality rates
The size of the abdominal wall defect, the extent to which organs protrude out of the abdomen, and the presence of other birth defects influence the outcome of the surgery. The occurrence of other birth defects is uncommon in infants with gastroschisis, and 85% survive. Approximately half of the babies diagnosed with omphalocele have heart defects or other birth defects, and approximately 60% survive to age one for Abdominal wall defect repair in Bangalore..
Gastroschisis is a life-threatening condition requir-ing immediate surgical intervention. There is no alter-native to surgery for either gastroschisis or omphalocele for Abdominal wall defect repair in Bangalore.