treatment of Gastroschisis/Exomphalos can only be finalised once the
baby is born and the medical team involved assess the situation. What
we have tried to do in this section is to give an overall idea of
what to expect. Since most surgeons and doctors each have their own
way of handling their jobs, we
have just outlined below the general steps taken in this procedure.
Once the baby is breathing
normally it is likely that a tube will be put up the baby's nose
and into his/her stomach. (The tube is called a naso gastric tube
or N.G.T. or N.G. tube). The N.G. tube will be left in place and
is used to get rid of excess air which could make the baby's bowel
more swollen. The baby's exposed parts are usually wrapped in surgical
cling film which further prevents the chances of infection.
The baby is placed in
an incubator and a drip inserted to enable antibiotics and fluids
to be given. Sometimes the baby might need a little extra oxygen
and this will be given via a head box or mask.
Once everything is stable
the surgical team will decide on one of two types of operation.
If there is only a small amount of bowel outside, it is most likely
that it will be returned to the baby's abdomen and the wound closed.
This is called a primary repair.
Sometimes if the Gastroschisis/Exomphalos
is large or if the abdominal cavity is small the surgeons will construct
a pouch in which the Gastroschisis/Exomphalos is placed. The pouch
is then suspended from the ceiling of the incubator and gravity
along with a reduction of the size of the pouch will help the Gastroschisis/Exomphalos
to slip back inside the abdomen.
This may take a week
or more in total and only then will the final closure occur. Occasionally
there is not enough skin to cover the affected area, and a patch
of silicone meshing or gortex patch is stitched to the skin. Over
the next few months the skin will slowly grow over the patch. This
type of surgery is called a staged repair.