Name of the Procedure:

Repair of Meningocele; Larger than 5 cm Diameter

Summary

In layman's terms, this procedure involves surgically correcting a meningocele—a type of spinal defect—when it is larger than 5 cm in diameter. The meningocele involves an abnormal sac protruding from the spinal column containing spinal fluid and meninges (the protective coverings of the spinal cord).

Purpose

The procedure addresses meningocele, a condition most often present at birth. The goals are to close the gap in the spine, prevent infection and further nerve damage, and improve the patient's mobility and function.

Indications

• Presence of a meningocele larger than 5 cm in diameter.
• Symptoms such as fluid leakage, infection, or nerve damage causing functional impairments.
• Potential or actual neurological deficits.
• Cosmetic concerns due to the large size of the meningocele.

Preparation

• Patients typically need to fast for at least 8 hours prior to surgery.
• Medication adjustments may be required; specific instructions provided by the healthcare team.
• Diagnostic tests like MRI or CT scans to assess the extent of the defect.
• Blood tests and other routine preoperative assessments.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made over the meningocele.
3. Exposure: The sac containing cerebrospinal fluid is carefully exposed.
4. Repair: The surgeon removes the meningocele sac and repairs the surrounding tissues and membranes.
5. Closure: The incision is closed with sutures, and a sterile dressing is applied.
6. Drain Placement: In some cases, drains may be placed to remove excess fluids postoperatively.

Tools include surgical scalpels, retractors, sutures, and possible use of microsurgical instruments.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity.

Setting

The procedure is performed in a hospital surgical suite.

Personnel

• Surgeon (usually a neurosurgeon or pediatric surgeon)
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Leakage of cerebrospinal fluid
• Anesthesia-related complications

Benefits

• Prevention of infection and further neurological damage.
• Improved neurological function and mobility.
• Reduction or elimination of symptoms related to meningocele.
• Enhanced aesthetic appearance in the affected area.

Recovery

• Initial hospital stay of 3 to 7 days post-procedure.
• Pain management with medications.
• Instructions for wound care.
• Restricted physical activity for several weeks.
• Follow-up appointments for monitoring and removal of sutures or drains.

Alternatives

• Observation and conservative management: Generally not recommended for large meningoceles due to risk of complications.
• Shunt placement: Sometimes used in conjunction with repair to manage hydrocephalus if present.
• Other neurosurgical interventions based on individual patient factors.

Patient Experience

• Patients will be under general anesthesia and will not feel anything during the procedure.
• Postoperative pain and discomfort managed with pain relief medications.
• Gradual improvement in symptoms and function as healing progresses.
• Regular follow-up care to monitor progress and address any complications.