Digestive and Gastrointestinal Conditions
All babies with gastroschisis need surgery shortly after birth to put their intestines back into their bellies. Because these babies need special care, it's best for them to be born at a hospital that has a Neonatal Intensive Care Unit (NICU). Many parents choose to have their babies transferred to Seattle Children’s for surgery because of our specialized expertise with children and gastroschisis.
Babies can be moved to our Level IV NICU for surgery and care after surgery. Seattle Children’s was the first hospital in Washington to have a Level IV NICU.
Surgery for Gastroschisis
Most of the time, babies with gastroschisis have surgery on the day they’re born. Sometimes, more than one procedure is needed to push the intestine back inside more gradually. The type of surgery needed will depend on your baby’s health and any bowel problems they have. Sometimes, the surgery can be done at the bedside and not require any stitches or even a general anesthetic. Sometimes, stitches and anesthesia are needed. Your surgeon will talk to you about the best treatment plan for your baby.
After birth, we will move your baby from the delivery room to a stabilization room to assess their condition closely. We monitor breathing and administer an IV (intravenous) line — a tube that goes into a vein to give fluids. They will also need a tube in the nose or mouth that goes down to the stomach and empties it. Some babies need to be on a breathing machine (ventilator) to temporarily help their lungs.
While your baby waits for surgery, your doctor will put a plastic bag around their intestines to protect them and keep them warm. Most of the time, it takes only one surgery to fit the intestines back inside. Our surgery team can use a new technique called sutureless umbilical closure that repairs gastroschisis using the umbilical cord and may allow closure without general anesthesia or closing the hole with stitches. This may make it less likely your baby will get an infection or have other complications.
In about 15% of infants with gastroschisis, there will not be enough room in the belly to put all the intestines back right away. In these cases, surgeons put the intestines in a bag that is attached to the baby’s belly. The intestines are squeezed back inside over 5 to 10 days. This lets the belly stretch and prevents damage to other organs.
After Surgery for Gastroschisis
It can take anywhere from one week to a few months for your baby’s intestines to start working. Your baby will likely need to be fed through a tube that goes into a large vein (central line) or a tube that passes through the nose or mouth into the stomach (nasogastric tube, NG tube; or orogastric tube, OG tube). We will give your baby medicine to reduce pain.
How severe your baby’s gastroschisis is and how long they will stay in the hospital can vary. After surgeons place the intestine back into the belly, your baby will need to be in the hospital until they can eat well. The average length of stay in the hospital for gastroschisis is about a month and a half.
As your baby’s health improves, we will move them from the NICU to a regular hospital room. This is usually a few days after the intestine is back in the belly and after we can remove the ventilator. At Seattle Children’s, babies with gastroschisis typically spend less time in the NICU than at other hospitals because our physicians, nurses and nutritionists have specialized expertise in helping children recover. This makes your family’s hospital stay less stressful and more comfortable.
Children with gastroschisis usually don’t have long-term problems or need to keep coming back to the hospital. Our doctors and nurses are always here to help you and answer questions.
To learn more about gastroschisis treatment at Seattle Children’s, call our General and Thoracic Surgery Department at 206-987-2794 x4.