Gastroschisis Repair—Child
Definition
Gastroschisis repair is surgery to close a gap in the abdominal wall. The gap is caused by a birth defect called a gastroschisis.
Reasons for Procedure
With a gastroschisis, the muscles and skin of the abdominal wall of a fetus do not close fully. As a result, abdominal tissue and organs can pass to the outside of the body.
Surgery is needed soon after birth to put the organs inside the body and repair the gap. More than one surgery may be needed. It depends on the size of the gap.
Copyright © Nucleus Medical Media, Inc.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Feeding problems
- Gastroesophageal reflux disease (GERD)
- Injury to intestinal tissue
- Twisting of or blockage in the intestine
- Nutrition problems if a large segment of small intestine was removed
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Specialists your baby may need to see
- Tests that may need to be done before surgery
Anesthesia
General anesthesia will be used. Your baby will be asleep.
Description of the Procedure
The extent of the surgery depends on the size of the gastroschisis. General steps may be:
- Opening a larger hole in the abdomen to examine the area and make room for the exposed tissue
- Removing any damaged intestine and connecting the healthy ends together
- Placing organs and other exposed tissue back into their proper place
- Repairing the abdominal wall and closing the opening
Intestines may be swollen and hard to put back into the abdominal cavity or there may not be enough room to fit them all in at first. Some intestine may be left outside of the abdomen and covered in a protective plastic device. The device will slowly push the intestines back into the abdomen as the swelling goes down or the abdominal cavity enlarges. More surgery will be needed to complete the repair and close the skin.
Immediately After Procedure
The baby will be taken to a recovery room and monitored.
How Long Will It Take?
It depends on how much repair is needed.
Will It Hurt?
Pain and swelling are common. Medicine and home care can help.
Average Hospital Stay
The length of stay depends on the repairs that were done. This may take 1 to 2 months.
Post-procedure Care
At the Hospital
Right after the procedure, the staff may give your baby:
- Pain medicines
- IV fluids and nutritional support
- Oxygen therapy and breathing support
During your baby's stay, staff will take steps to lower the chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your baby’s incisions covered
You can also lower your baby's chance of infection by:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others 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 the right amount of nutrition.
Call Your Doctor
Call the doctor if your child is not getting better or has:
- Signs of infection, such as fever or chills
- Redness, swelling, excessive bleeding, or any discharge from the incision
- Signs of pain, such as irritability
- New or worsening symptoms
Call for emergency medical services right away if your baby has:
- Problems breathing
- Signs of bowel obstruction, such as:
- High fever
- Signs of pain when the belly is touched
- Abdominal swelling or hardness
- Green or yellow vomit
If you think your baby is having an emergency, call for medical help right away.
RESOURCES:
Centers for Disease Control and Prevention
http://www.cdc.gov
March of Dimes
http://www.marchofdimes.org
CANADIAN RESOURCES:
March of Dimes Canada
http://www.marchofdimes.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca
REFERENCES:
About gastroschisis. The Children’s Hospital of Philadelphia website. Available as: http://www.chop.edu/conditions-diseases/gastroschisis/about#.VPuPR46j99k. Accessed November 4, 2020.
Facts about gastroschisis. Centers for Disease Control and Prevention website. Available as: http://www.cdc.gov/ncbddd/birthdefects/Gastroschisis.html. Accessed November 4, 2020.
Gastroschisis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gastroschisis. Accessed November 4, 2020.
Skarsgard ED. Management of gastroschisis. Curr Opin Pediatr. 2016 Jun;28(3):363-369.
Last reviewed September 2020 by EBSCO Medical Review Board Kari Kassir, MD Last Updated: 5/11/2021