Repair of small omphalocele, with primary closure
CPT4 code
Name of the Procedure:
Repair of small omphalocele, with primary closure
(Omphalocele Repair, Omphalocele Correction Surgery)
Summary
An omphalocele is a birth defect where an infant's intestines, liver, or other organs protrude outside the abdomen through the belly button. This surgical procedure involves repositioning these organs into the abdominal cavity and closing the opening in the abdominal wall.
Purpose
This procedure addresses the congenital defect of omphalocele to protect exposed organs, reduce the risk of infection, and allow the organs to function properly within the body cavity.
Indications
- Infants diagnosed with omphalocele through prenatal imaging or at birth
- Signs of compromised organ function or the risk of damage to the exposed organs
- The need to prevent infection and improve the overall health of the newborn
Preparation
- Preoperative fasting (no breast milk for at least 4 hours and no formula for at least 6 hours before surgery)
- Blood tests and imaging studies to assess the extent of the defect and the position of organs
- Consultation with a pediatric surgeon and anesthesiologist
Procedure Description
- Anesthesia: The infant is given general anesthesia to ensure they are asleep and pain-free during the surgery.
- Incision: A small incision is made around the base of the omphalocele sac.
- Repositioning Organs: The surgeon carefully places the exposed organs back into the abdominal cavity.
- Closure: The abdominal wall muscle and skin are sutured closed.
- Monitoring: The infant is closely monitored throughout the procedure for any signs of distress or complications.
Tools used include surgical scalpels, sutures, retractors, and sterilized drapes.
Duration
The procedure typically takes 1 to 3 hours, depending on the complexity and size of the omphalocele.
Setting
The procedure is performed in a hospital operating room, equipped with specialized neonatal surgical facilities.
Personnel
- Pediatric Surgeon
- Anesthesiologist
- Surgical Nurses
- Neonatologist (if needed)
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Respiratory issues from anesthetic
- Bowel obstruction or adhesions
- Rarely, injury to the organs during surgery
Benefits
- Protection of organs from damage and infection
- Improved chances for normal digestion and growth
- Enhanced overall health and development post-surgery Benefits are typically realized within days to weeks after successful closure and healing.
Recovery
- Postoperative monitoring in a neonatal intensive care unit (NICU)
- Pain management with medications
- Gradual reintroduction of feeding as tolerated
- Instructions on wound care and signs of complications
- Follow-up appointments for surgical site inspection and overall health assessment Recovery times vary, but infants usually spend 1 to 2 weeks in the hospital.
Alternatives
- Staged closure (for larger omphaloceles)
- Conservative management with topical treatments and delayed surgery The primary closure procedure is generally preferred for small omphaloceles due to quicker recovery and fewer complications.
Patient Experience
- During the procedure, the infant is under general anesthesia and will not feel pain or be aware of the surgery.
- Post-surgery, the baby might experience discomfort managed with medications.
- Parents might feel anxious; supportive care includes counseling and regular updates from the medical team.