Primary reduction of the eviscerated visceral bulk present in gastroschisis and large omphalocele can cause elevation of the diaphragm, compression of the vena cava, and pressure on the viscera due to the significant disproportion between extra-abdomi...
Primary reduction of the eviscerated visceral bulk present in gastroschisis and large omphalocele can cause elevation of the diaphragm, compression of the vena cava, and pressure on the viscera due to the significant disproportion between extra-abdominal bulk and capacity of the abdominal cavity. A similar discrepancy also exist between the amount of viscera reduced and the space available to accomodate such within the peritoneal cavity following repair of the major diaphragmatic hernia. Many techniques have been suggested as a means of circumventing this loss of intra-abdominal domain for protruding viscera. But none has proved to be the foolproof.
The ideal repair is complete primary closure without compressing and compromising the respiratory state, venous return, or intestinal blood supply.
I, the author, have applied a new procedure to the abdominal muscles of five puppies with various weights, and measured before and after this proecdure, inferior vena cava pressure and intra-gastric pressure versus air volume of the balloon in the abdominal cavity before and after application of this procedure, respectively. The result is that the capacity of abdominal cavity can be increased by this procedure. So I'd like to introduce this procedure as one method of primary closure of gastroschisis and omphalocele.