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Giant Omphalocele
Compiled from across the library · built automatically
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
If the surgical technique for omphalocele closure involves exposing the intestines, it may be worth considering a Ladd procedure, but not worth going through the sac if the technique maintains the sac. Gastroschisis - Clinical Practice Updates · 10:31
Approach and component separation for suture closure and underlay mesh...
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During the Pediatric Surgery Tricks of the Trade and Difficult Cases: Innovative Solutions to Common Problems Course in 2013, directors DrsTodd Ponsky, Robert Parry, and Jacob Langer, along with faculty including Drs David van der Zee, Suad
video31:03 · Sep 2018
Tricks - Omphalocele - Approach & Component Separation For Suture Closure &...
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This segment displays a presentation of omphalocele, separation of components and closure of the abdominal wall. The topics discussed include incision placement, component separation, patch closure, ideal time to operate, early versus delay
video32:30 · Nov 2018
Gastroschisis - Clinical Practice Updates
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This clip from the 2020 Pediatric Surgery Update Course features, Miguel Guelfand, MD; Shawn St. Peter, MD; and Saleem Islam, MD; presenting challenging cases for review by our panelists.
Highlighted Topics Include:
- Omphalocele
- Pul
video · Sep 2020
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
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Anna-Maria Ziegler, Daniel Svoboda, Britta Lüken-Darius, Andreas Heydweiller, Fritz Kahl, Sophie Christine Falk, Udo Rolle, Till-Martin Theilen
Purpose: Abdominal wall closure in patients with giant omphalocele (GOC) and complicated gast
video0:56 · Nov 2024
A multi-institutional comparison of management techniques for infants with giant omphalocele
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Alyssa Stetson, Samantha Leonard Katherine Flynn-O'Brien, Seth Goldstein, Tiffany Wright, Cynthia Downard, Kyle J Van Arendonk, Charles M Leyes, Linda Cherney-Stafford, Karen Speck, Peter C Minneci, Troy A Markel, Shawn D St Peter, Dave La
video0:51 · Jan 2026
Reduction rate varies by patient: some can tolerate 2 centimeters per day, others only 1 centimeter per week, depending on comorbidities and development of pulmonary hypertension — Miguel Guelfand, EUPSA Webinar "GIANT OMPHALOCELE II" · 54:28
EUPSA Webinar "GIANT OMPHALOCELE II"
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Marlinde van den Kamp (The Netherlands)
Miguel Guelfand (USA)
Moderated by
Martin Lacher (Germany)
Augusto Zani (Canada)
video1:04:07 · Jul 2026
Complex gastroschisis is almost a different disease from simple variety; everything is worse including hospital length of stay, requirement for further operations, and sepsis rates Update Course Rewind: Omphalocele & Gastroschisis 2020 · 12:25
Update Course Rewind: Omphalocele & Gastroschisis 2020
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Abdominal wall defects like omphalocele and gastroschisis can present in interesting ways. At last year
podcast15:18 · Jun 2026
What is Omphalocele? An ERNICA animation for parents and families
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Animation video [in English]. Target audience: Parents and families. The video could also be used as an explanatory tool by healthcare professionals.
For further details about this condition, possible complications and specialised care,
video3:19 · Dec 2023
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A multi-institutional comparison of management techniques for infants with giant omphalocele
The study examined 117 infants with giant omphalocele.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:07 ↗
Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:07 ↗
Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:19 ↗
Approximately 80% of infants treated with Duoderm silo achieved single-stage abdominal closure.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:24 ↗
Some babies treated with operative silos achieved closure sooner than other methods.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:25 ↗
The overall chance of complications was similar across all four treatment methods.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:25 ↗
Almost half of the infants required six months or more before complete abdominal closure could be achieved.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:32 ↗
There is no one-size-fits-all treatment for giant omphalocele.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:38 ↗
Duoderm silos may be a particularly good option when the goal is single-stage abdominal closure.
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:38 ↗
Tricks - Omphalocele - Approach & Component Separation For Suture Closure &...
In patients without pulmonary hypoplasia or bad heart problems, first choice is to try early coverage because it is quicker and easier.
opinionBob Langer0:51 ↗
For patients with pulmonary hypoplasia, bad hearts, prematurity, or where the omphalocele is too big and there isn't enough skin to get over, the escharotic technique is used.
clinicalBob Langer1:05 ↗
Silver sulfadiazine (Flamazine in Canada) has been used for many years for omphalocele escharization, as taught by Sigy Ein.
clinicalBob Langer1:09 ↗
Silver-impregnated sponges offer the same advantage as Silvadene but are less messy and don't require painting.
clinicalBob Langer1:44 ↗
Silver Aquacel stuck to the omphalocele sac and became incorporated, failing to fall off as expected once it hardened underneath.
clinicalTodd Ponsky1:54 ↗
Component separation requires going up every day to adjust the compression, which is work-intensive.
clinicalBob Langer5:12 ↗
The most difficult cases are patients with pulmonary hypoplasia or bad hearts where intra-abdominal pressure cannot be safely increased.
clinicalBob Langer5:12 ↗
The objectives of component separation are to minimize postoperative risk of abdominal hypertension and compartment syndrome, increase abdominal capacity at closure, facilitate anatomically definitive midline closure regarding rectus muscles, and limit evisceration and incisional hernias.
Host summaryThe host summarizing a resource — not the host's own clinical position6:19 ↗
The case presented was a 28-week gestation, 1,130g premature female with giant omphalocele including the liver, identified by prenatal ultrasound.
Host summaryThe host summarizing a resource — not the host's own clinical position6:42 ↗
After 10 days of manipulation with the Duoderm silo, the peritoneal sac was still covered, thick, and manageable.
Host summaryThe host summarizing a resource — not the host's own clinical position7:12 ↗
The incision is made 0.5 to 1 centimeter outside the semilunar line, with dissection of the lateral fascia towards the external oblique.
Host summaryThe host summarizing a resource — not the host's own clinical position7:57 ↗
By dissecting the fascia to the mid-axillary line, you can gain between 2 and 4 centimeters of advancement.
Host summaryThe host summarizing a resource — not the host's own clinical position8:26 ↗
This case represents the probable smallest patient with lowest weight and giant omphalocele treated with Abello method and component separation for definitive anatomic closure without evisceration.
Host summaryThe host summarizing a resource — not the host's own clinical position10:19 ↗
Concern exists about whether abdominal wall musculature after component separation in a 1.3kg infant will function normally at 20 years of age.
opinionBob Langer11:41 ↗
Using an absorbable patch leaves the abdominal wall musculature intact, and as the child grows, the patch becomes a smaller percentage of the abdominal wall area.
clinicalBob Langer12:00 ↗
Surgisis was used for a long time but had many recurrences; now Strattice is used with better results.
clinicalBob Langer12:00 ↗
Many omphaloceles have defects that go right up to the costal margin, making it difficult to close that area even with component separation.
clinicalBob Langer12:36 ↗
Often the lower part of the defect is closed primarily, but a patch is needed along the costal margin.
clinicalBob Langer12:50 ↗
Component separation dissection to the mid-axillary line is necessary to adequately mobilize tissue and achieve closure.
clinicalTodd Ponsky13:20 ↗
Six-ply Surgisis with 22 tension lines works better, allowing tension on the patch while bringing the fascia together.
clinicalTodd Ponsky13:31 ↗
Dr. Abello has long-term follow-up with the Duoderm technique showing all patients healed well without problems.
Host summaryThe host summarizing the discussion — not the host's own clinical position14:07 ↗
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