Health Encyclopedia

Gastroschisis repair

Definition

Gastroschisis repair is surgery to correct a congenital (present at birth) defect of the abdominal wall (gastroschisis). The surgery places a bulging part of the small intestine and other internal organs back into the abdominal area.

Alternative Names

Abdominal wall defect repair

Description

Immediately after delivery, any organs outside of the baby's body are covered with warm, moist, sterile bandages. A nasogastric (NG) tube is inserted through the baby's nose or mouth into the stomach to keep the stomach empty and to prevent choking on or breathing stomach contents into the lungs. This surgery is done as soon as the infant is stable.

The baby will be under general anesthesia (unconscious and pain-free) during the surgery. The surgeon examines the intestine closely for signs of damage or additional birth defects. Damaged or defective parts are removed and the healthy edges are stitched together.

The abdominal organs are placed back into the abdomen through defective opening and the opening is repaired, if possible. If this can't be done right away, a pouch is created to protect the intestines, which are slowly pushed back into the abdomen over a period of time. Surgery may be necessary to repair the abdominal muscles at a later time.

Indications

This procedure is used to repair gastroschisis, a life-threatening birth defect that requires immediate attention at birth.

Risks

The baby's abdomen may be smaller than normal. Placing the abdominal organs into the abdomen increases the pressure within the area and may cause breathing difficulties. The infant may need a breathing tube and breathing machine for a few days or weeks.

Other risks of major abdominal surgery include inflammation of the tissue that lines the wall of the abdomen and temporary paralysis of the small bowel.

If a large part of the small bowel is damaged, the infant may have problems digesting and absorbing nutrients from feedings.

Expectations after surgery

The defect can be corrected with surgery in most cases. How well the baby does depends on the amount of damage to the intestine.

Convalescence

After surgery, the infant will stay in the hospital's neonatal intensive care unit (NICU). The baby will be placed in special warmer to prevent infection. Antibiotics, pain medication, fluids given through a vein, and oxygen will be given. A breathing machine is often needed.

Feedings are started very slowly through the nasogastric tube as soon as the intestines start to work. Infants are often reluctant to feed. An infant who has had this surgery may need feeding therapy, lots of encouragement, and time to recover.

Review Date:10/19/2007
Reviewed By:Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

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