Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room
CPT4 code
Name of the Procedure:
Repair of Large Omphalocele or Gastroschisis; with Removal of Prosthesis, Final Reduction and Closure
Summary
This procedure involves repairing a large congenital abdominal wall defect (omphalocele or gastroschisis). It includes removing a prosthetic device used to temporarily protect the abdominal organs, followed by reducing the organs back into the abdominal cavity, and closing the abdominal wall.
Purpose
The procedure addresses congenital defects where abdominal organs protrude outside the body due to an opening in the abdominal wall. The goal is to safely reposition these organs inside the abdomen and close the defect, ensuring proper development and function of the abdominal organs.
Indications
- Infants born with omphalocele or gastroschisis.
- Presence of a prosthetic device protecting the organs.
- Stable health condition of the infant, making final closure possible.
Preparation
- Preoperative fasting as directed by the healthcare provider.
- Adjustments to medication as advised.
- Comprehensive diagnostic tests including ultrasounds and blood work.
- Detailed physical examination.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made to access the prosthetic device.
- The prosthesis is carefully removed.
- The abdominal organs are gently repositioned inside the abdominal cavity.
- The abdominal wall defect is closed with sutures or surgical staples.
- A sterile dressing is applied to the incision site.
Duration
Typically, the procedure takes 2-4 hours, depending on the complexity of the case.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Pediatric surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Anesthesia-related complications
- Damage to internal organs
- Recurrence of the abdominal wall defect
- Adhesions or bowel obstruction
Benefits
- Correcting the congenital defect
- Enabling normal development and function of abdominal organs
- Reducing the risk of future complications related to the defect
Recovery
- Close monitoring in a neonatal intensive care unit (NICU).
- Postoperative pain management.
- Gradual introduction of feedings.
- Regular follow-up appointments to monitor healing and growth.
- Recovery typically spans several weeks to months, depending on the infant’s overall condition.
Alternatives
- Conservative management with a staged closure process.
- Non-surgical methods of temporary protection and gradual reduction.
- Each alternative carries its own risks and benefits and is chosen based on the patient’s condition severity and overall health.
Patient Experience
- The infant will be under anesthesia during the procedure and will not feel pain.
- Postoperatively, the healthcare team will manage pain through appropriate medications.
- Parents can expect a gradual return to normal activities as the infant recovers.