Bogota MIN.pdf
Transcript of Bogota MIN.pdf
Closure of Gastroschisis
Muhammad Amin
Introduction
• Gastroschisis is a congenital condition, characterised by a full-thickness defect in the anterior abdominal wall, with intestinal herniation.
• Managed by primary closure or staged closure.
Gastroschisis
Staged Closure
Pre-formed Silo
Surgical Silo
Primary Closure
Primary Closure
• Firstly reported in 1878 fatal outcome.
• Watkins, 1943: Reported the first successful primary closure of gastroschisis.
• Moor and Stokes, 1953: Reported the use of skin flap technique to close the abdomen two of the patients died because of acute respiratory insufficiency and ACS.
• Izan et al, 1966: Manual stretching of the abdominal wall Complicated by lateral abdominal wall hernia.
Staged Closure: Surgical Silo
• Also known as: Bogota Bag, Modified Bogota Bag, Hand-sewn Silo.
• Bogota Bag is a sterile plastic bag used for closure of an abdominal wound. Its use was first described in 1984 by Oswaldo Borráez in Bogotá, Colombia.
• Schuster, 1967: Used sheets of Teflon as a temporary covering for the herniated bowel.
• Allen and Wrenn modified Schuster’s technique by using silastic instead of Teflon.
• Shermata and Haller, 1975: Used a preformed transparent silo sutured to the abdominal wall.
Bogota Bag dr. Oswaldo Borráez
Surgical silo
Staged Closure: Pre-formed Silo
• Also known as: Silastic Silo, Spring-loaded Silo, Gastroschisis Bag.
• Starting from 1997, surgeons began inserting a silastic silo or a spring-loaded silo.
Pre-formed Silo
The Differences
Surgical Silo Pre-formed Silo Should be placed at operating room
Could be placed at bedside
Need for suturing to the abdominal wall
No need for suturing
Performed under general anesthesia
Could be performed using anelgesia alone
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