Tuesday, August 8, 2017

Pediatric surgery abdomonal wall defects

Abdominal Wall Defects
Definition
In babies with congenital umbilical wall defect gastroschisis and ruptured omphalocele.
Objectives
   To reduce the bowel inside the abdominal cavity
   To close the defect primarily if feasible
   To increase the abdominal cavity by a pouch, if required.
Position
Supine.
Anesthesia
General with endotracheal intubation.
Procedure
1.  Enlarge the defect transversely in the case of gastroschisis.
2.  Excise the remaining sac in the case of ruptured omphalocele and enter the abdominal cavity.
3.  Stretch the anterior abdominal wall. Try to close the defect in layers, if feasible.
4.  Create a pouch of marlex or prolene mesh.
5.  Suture the pouch all around the defect in 2 layers.
6.  Clamp the excess of pouch to force reduce the bowel into the abdominal cavity in stages.
Instruments
General pediatric set.
Sutures
   Catgut                   4/0
   Nylon                                 3/0

   Marlex mesh.

Any questions be sent to drmmkapur@gmail.com  
All older posts are stored in archive for accessand reiew
Thosewho follow may post contributions to the site,please writo tp address above.
To create consumer/provider enagement visit www.surginstruatlas.blogspot.com 
www.drmmkapur.blogspot.com                   www.surgseminar.blogspot.com  
Also available now on android & smartphones same internet address

Complete set of blogs & precepts available at distance  learning support Tryselfcar


No comments:

Post a Comment