Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
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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
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
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 · Feb 2026
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
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
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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Giant omphalocele is a birth condition where an opening at the baby's belly button allows organs—sometimes including the liver—to sit outside the body in a protective sac. The cause is unknown, and many babies have other health challenges or genetic conditions. Doctors can see it on ultrasound before birth. After delivery, the organs are wrapped carefully to keep them safe. Small omphaloceles can often be repaired in one surgery, but giant ones usually need several steps over weeks or months because the baby's belly may not yet be big enough to hold everything. Physicians discussed several techniques: some use special dressings (like Duoderm or hydrocolloid) to gently compress the sac and help organs move back in; others apply silver cream to harden the sac and wait for the baby to grow before closing; and some perform component separation, a surgery that stretches the abdominal muscles to make room. Most babies do survive, though hospital stays vary and close follow-up is essential.
Giant omphalocele is a birth condition where an opening at the baby's belly button allows organs—sometimes including the liver—to sit outside the body in a protective sac. The cause is unknown, and many babies have other health challenges or genetic conditions. Doctors can see it on ultrasound before birth. After delivery, the organs are wrapped carefully to keep them safe. Small omphaloceles can often be repaired in one surgery, but giant ones usually need several steps over weeks or months because the baby's belly may not yet be big enough to hold everything. Physicians discussed several techniques: some use special dressings (like Duoderm or hydrocolloid) to gently compress the sac and help organs move back in; others apply silver cream to harden the sac and wait for the baby to grow before closing; and some perform component separation, a surgery that stretches the abdominal muscles to make room. Most babies do survive, though hospital stays vary and close follow-up is essential.
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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-surgery 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 ↗
Complication rates were similar across all four management methods
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:25 ↗
Almost half of infants required 6 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 universal best treatment approach for giant omphalocele
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:38 ↗
Duoderm silos may be particularly beneficial when the goal is single-stage abdominal closure
Host summaryLizzie Lee summarizing a resource — not the host's own clinical position0:38 ↗
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 ↗
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