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Omphalocele Repair—Child

Definition

Omphalocele repair is a surgical procedure to close a gap in the abdominal wall. The gap is caused by a birth defect.

Reasons for Procedure    TOP

With an omphalocele, the muscles and skin around the belly button do not close completely before the baby is born. As a result, abdominal tissue and organs, like the intestine, may be outside of the abdominal cavity. The misplaced abdominal tissue and organs are enclosed in a sac.

The omphalocele may be small with just a section of intestines or can be large and involve several abdominal organs, including the liver.

Surgery may be done soon after birth or when the baby is strong enough, depending on the size of the defect. The eventual goal of surgery is to put the abdominal tissue back in place, and repair the defect in the abdominal wall. There may be multiple, progressive steps needed to complete this process.

Normal Anatomy of the Abdominal Organs

nucleus fact sheet image
Copyright © Nucleus Medical Media, Inc.

Possible Complications     TOP

Problems from the procedure depend on the size of the defect. Complications may include:

What to Expect    TOP

Prior to Procedure

If the gastroschisis is found before birth, a birth plan will be made to decrease the risk of further damage.

After birth, supportive steps before the surgery may include:

  • The sac will be protected in a sterile dressing
  • If the sac ruptures, the exposed tissue will be wrapped in a plastic device to protect the organs
  • IV fluids and nutrition
  • Nasogastric tube to help reduce the size of the exposed tissue by removing air from the stomach and intestines
  • Watching for complications, such as shock, heat loss, dehydration, or bowel obstruction

Anesthesia

General anesthesia is used. The baby will be asleep during the procedure.

Description of the Procedure     TOP

The extent of the surgery depends on the size of the omphalocele. When possible, organs and other exposed tissue are placed back into their proper place. The abdominal wall is repaired and stitched.

Intestines may be swollen and difficult to place back into the abdominal cavity or there may not be enough room to fit them all initially. The sac will be covered in a mesh device that will support the structures. Slow tightening of the device will allow the intestines to be gradually pushed back into the abdomen as the abdominal skin grows enough to cover the area. Later surgeries will complete the repairs and close the skin.

Immediately After Procedure     TOP

The baby will be taken to a recovery room and monitored.

How Long Will It Take?     TOP

It depends on how much repair is needed.

How Much Will It Hurt?     TOP

Anesthesia prevents pain during surgery. Additional medication will be given to relieve pain or soreness during recovery.

Average Hospital Stay     TOP

The length of stay depends on the extent of the repair needed. Proper feeding, weight gain, and bowel function are needed before the baby can go home. This may take several days or weeks.

Post-procedure Care     TOP

At the Hospital

A neonatal intensive care unit will monitor blood pressure, pulse, and breathing. Recovery may also include:

  • Pain medications
  • Antibiotics to prevent infection
  • IV fluids and nutritional support
  • Oxygen therapy
  • Mechanical ventilation

The hospital staff will take steps to reduce the chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your baby’s incisions covered

There are also steps you can take to reduce your baby’s chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding their healthcare providers to wear gloves or masks
  • Not allowing others to touch your baby’s incisions

At Home

Recovery may take some time and require a special diet. The doctor will monitor the baby’s growth and overall health to make sure the baby is getting adequate nutrition.

Call Your Doctor     TOP

It is important to monitor your baby's recovery after they leave the hospital. Alert your baby's doctor to any problems. If any of the following occur, call your baby's doctor:

  • Signs of infection, including fever or chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • New or worsening symptoms

Call for emergency medical service right away if your baby has:

  • Difficulty breathing
  • Signs of bowel obstruction, such as:
    • High fever
    • Localized abdominal tenderness
    • Abdominal swelling or hardness
    • Green or yellow vomit

If you think your baby has an emergency, call for emergency medical services right away.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES:

March of Dimes Canada
http://www.marchofdimes.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

About Omphalocele. The Children’s Hospital of Philadelphia website. Available as:
...(Click grey area to select URL)
March 2013. Accessed May 3, 2016.
Facts About Omphalocele. Center for Disease Control and Prevention website. Available as:
...(Click grey area to select URL)
Updated November 17, 2015. Accessed May 3, 2016.
Omphalocele. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated January 7, 2015. Accessed May 3, 2016.
Last reviewed June 2016 by Michael Woods, MD
Last Updated: 6/14/2016

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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