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.
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